Super Kids’ Place (Jones)
Emergency Evacuation Form
Please sign & return this form
I understand that in case of an emergency evacuation during Super Kids’ Place time my child/ren
__________________________ will walk to Woods Memorial Church in Severna Park. Parents will pick up their
children as soon as possible after being notified of the situation.
Parent’s Signature _________________________________
Home Address ____________________________________
Home Phone ___________________ Cell Phone ___________
Work Phone _________________________
Another Emerg. Contact _________________________________________________________
Emergency Evacuation Form
Please sign & return this form
I understand that in case of an emergency evacuation during Super Kids’ Place time my child/ren
__________________________ will walk to Woods Memorial Church in Severna Park. Parents will pick up their
children as soon as possible after being notified of the situation.
Parent’s Signature _________________________________
Home Address ____________________________________
Home Phone ___________________ Cell Phone ___________
Work Phone _________________________
Another Emerg. Contact _________________________________________________________