Contact and Medical Information Student & Contact InfoStudent Name* First Last Student Grade*Casa ACasa BCasa CCasa DGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8HifdhStudent Section*ABN/AFathers' Name* First Last Fathers' Email* Father's Contact Number*Mothers' Name* First Last Mothers' Email* Mothers' Contact Number*Name of Sibling(s)/Grade(s)*Attending AHES (if no siblings write 'N/A')Emergency Contact InfoContacts other than parentsEmergency Contact #1 Name* First Last Emergency Contact #1 Number*Emergency Contact #1 Relation*Emergency Contact #2 Name* First Last Emergency Contact #2 Number*Emergency Contact #2 Relation*Medical InfoDoes your child have a Medical Condition (ex: allergy, skin condition, health concern, etc)?*YesNoPlease specify details about the Medical Condition(s).*Medication Required at School*YesNoHave you submitted a letter from your doctor stating this medical condition for the new academic year, Sep 2018 -June 2019?*YesNoIf your child is on Epipen, please provide the valid Anaphylaxis Emergency Plan -(Click here for the Form) to the office at your earliest but no later than Monday, September 10th, 2018. Please note that: It is the parent's responsibility to provide 2 Epipens to school; 1 for the office and 1 for the classroom along with the Anaphylaxis Emergency Plan. Checking the expiration date on the Epipen is also the parent's responsibility. Please ensure that the Students name, grade and section are clearly labeled on both the Epipens provided. It is recommended that students on Epipen wear a MedicAlert wrist band to school at all times.