ECC Emergency Information Form 2020-2021

Park Avenue Synagogue Early Childhood Center

ECC Emergency Information Form 2020-2021


Please complete this form by Friday, September 4, 2020.

Child’s Information



MM/DD/YYYY







In case of emergency, please notify:


























P.M. Pickup Information:







Allergies/Special Health Needs

If your child has any allergies or special health needs, your doctor must complete the Allergy/Special Health Care Plan and the Medication Consent Form. After submitting this form, you will be able to return to the Student Forms section of the ECC website, where you will find both of these forms.
If you have any questions, please contact the ECC Office at (212) 369-2600, x150 or at ECCOffice@pasyn.org.