Student Emergency Release Form - 2019/2020

  • Student / Teacher Information

  • * = Required Field


  • Parental Email

  • After this form is submitted we will send you an email notification.

  • Parent / Guardian #1 Contact Information


  • Parent / Guardian #2 Contact Information


  • Medical Information


  • Emergency Contacts

  • (at least one should live locally if possible.)

  • Out of Province Contacts

  • Confirmation

  • In case of an emergency I grant Navigate-NIDES permission to release my son or daughter into the care/guardianship of any of the above name people.

  • This field is for validation purposes and should be left unchanged.