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FOR LIFE THREATENING EMERGENCIES:CALL 911FAMILY NAME: _____________________________________________________ CHILDREN'S NAMES: ______________________________________________AGE:_______________ ______________________________________________AGE:_______________ ______________________________________________AGE:_______________ ______________________________________________AGE:_______________ FAMILY ADDRESS:_________________________________________________ NEAREST CROSS STREETS:_________________________________________ NUMBER TO CONTACT PARENTS:_____________________________________ DOCTOR'S NAME:__________________________PHONE:__________________ HOSPITAL:________________________________PHONE:__________________ POISION CONTROL CENTER ___________________ (look up your area's number) NEIGHBOR TO CONTACT FOR HELP:___________________________________ NEIGHBOR PHONE NUMBER:_________________________________________ ADDITIONAL INSTRUCTIONS:_________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ Print this form and take it with you when you have a babysitting job! It may help save your life!
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