Emergency Form

Emergency Form 2017-18; required by 8/1/17

The items in this form are required by the State of Virginia Department of Social Services.

Child name & birthday, parent(s) names, email addresses, telephone numbers, and addresses are distributed at the beginning of the year. Please provide the best contact information for your child’s school community.

State law requires emergency contacts be within 25 miles of UMS

State law requires emergency contacts be within 25 miles of UMS

*If there is an objection to seeking emergency medical care, a statement should be obtained from the parent(s) or guardian(s) that states the objection and the reason for the objection

Active Ingredients: Avobenzone, homosalate, octocrylene. Inactive ingredients: aluminum starch octenylsuccinate, benzyl alcohol, butyloctyl salicylate, carbomer, dimethicone, disodium EDTA, methylparaben, polyglyceryl-3 distearate, propylparaben, sorbitan isostearate, sorbitol, stearic acid, tocopherol, triethanolamine, vp/eicosene copolymer, water

put in product description/ingredients