Annual Student Emergency Form

Every Canterbury student must have emergency information on file with the school before the first day of classes.

The school collects this information annually via an online form, which includes:

  • Emergency Information
  • Permission to Treat
  • Allergy Information
  • Tylenol Permission
  • Field Studies/Trips Permission
  • Authorization for Medical Treatment
  • Assumption of Financial Responsibility

Please complete one form per student.

Information provided in this form will be maintained in school offices for every enrolled student. Emergency and Permission to Treat information will also be shared with the Middle and High School Athletics Offices, for students participating in sports.

Please note: You must complete all required fields in order to successfully submit the form. When you hit the "Submit" button, an on-screen message will appear, indicating the form was submitted successfully. You will receive a receipt of the form (usually within 30 minutes) to the email address you provided.

Please complete for 2018-19.