Unlock hundreds more features
Save your Form to the Dashboard
View and Export Results
Use AI to Create Forms and Analyse Results

Forgot Password?
Get Started
OR
Sign UpLogin With Facebook
Sign UpLogin With Google

Daycare Emergency Contact Form Template

Ensure Safety with Our Daycare Emergency Contact Form

If an emergency occurs, having immediate access to contact details can make all the difference. This daycare emergency contact form template helps you easily gather essential information from parents and guardians, ensuring quick communication when it matters most. With this template, you can quickly compile contacts, improve preparedness, streamline emergency response, and maintain compliance-all while ensuring WCAG-aligned accessibility. Explore our live template today to simplify your daycare's emergency plans.

Use this Template (FREE) Live Preview
Child full name
Child date of birth
Home address
Primary parent/guardian full name
Primary parent/guardian phone
Primary parent/guardian email
Secondary parent/guardian full name
Secondary parent/guardian phone
Primary parent/guardian relationship to child
Mother
Father
Legal guardian
Stepparent
Grandparent
Other
Please Specify:
Emergency contact full name
Emergency contact relationship to child
Grandparent
Aunt/Uncle
Family friend
Neighbor
Babysitter
Other
Please Specify:
Emergency contact phone
Is this emergency contact authorized to pick up the child?
Yes
No
Primary care physician full name
Physician phone
Insurance provider and policy number
Known allergies (select all that apply)
Please Specify:
Ongoing medical conditions
Current medications
Epinephrine auto-injector (EpiPen) is provided and kept on site
Yes
No
Permission to administer basic first aid if needed
Yes
No
Consent to seek emergency medical treatment and transport if necessary
Yes
No
Name of parent/guardian signing
Signature of parent/guardian
Date signed
I certify the information provided is accurate and I will update the daycare with any changes
Strongly disagree
Disagree
Neither
Agree
Strongly agree
{"name":"Child full name", "url":"https://www.quiz-maker.com/QPREVIEW","txt":"Child full name, Child date of birth, Home address","img":"https://www.quiz-maker.com/3012/images/ogquiz.png"}
paper art illustration of a daycare emergency contact form with various sections and contact details highlighted

When to use this form

Use this form when you enroll a child, update records at the start of a term, or anytime a family moves, changes numbers, or custody shifts. It helps you store who to call first, who else to try, pickup permissions, and medical consent, so staff can act fast. Pair it with the Personal data sheet form to capture parent details and the child's info in one place, and use the Next of kin form for additional backup contacts. If you also oversee staff on site, the Employee emergency contact form keeps your team covered during incidents. The result: fewer delays, clear decision paths, and peace of mind for families and caregivers.

Must Ask Daycare Emergency Contact Questions

  1. Who is the primary emergency contact and what is their relationship to the child?

    This tells staff who to call first and confirms the contact's authority. Listing the relationship reduces confusion during stressful moments.

  2. What are the best phone numbers for the primary and backup contacts, and in what order should we call them?

    Priority and current numbers prevent phone tag in urgent cases. Include mobile, work, and any alternate numbers to improve reach.

  3. Who is authorized to pick up your child, and what photo ID will they present?

    Clear pickup rules protect children and staff. Noting expected ID types helps us verify identity quickly at pickup.

  4. Does your child have any allergies, medical conditions, medications, and a primary physician we should list?

    Specific health details guide safe care and triage. Physician contact and clinic info speed up coordination with medical staff.

  5. Do you give permission for staff to seek emergency medical treatment, including transport, if we cannot reach you?

    Documented consent removes delays when minutes matter. It also shows families exactly how you will act in a true emergency.

More Forms

Copy/Edit Form Send to Recipients Make a Form w/AI Form Builder Must Ask Questions
  • 100% Free - No Catches
  • Collect Responses Today
  • Tailor to your Look & Feel