PCC Canto Emergency Contact/Health Info

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The information collected in this form will be used solely for chorister, chaperone, and staff safety during Canto Tour. The information is confidential and shared only with healthcare professionals on tour and relevant PCC staff members.

First Name *

Last Name *

Select Role *

Chorister

Chaperone

Staff Member

Board Member/Medical Team

Emergency Contact Name *

Please select a person who is not going on tour as an Emergency Contact

Emergency Contact Phone Number *

ANY rescue medication should always accompany the chaperone/staff for PCC travel. Rescue medication is life-saving medication such as Epi-pens, Auvi-Q, inhalers, diabetic or seizure medications.

I understand and agree that rescue meds will go on tour. *

Yes

Are there any allergies, medication, or medical conditions you want to share with us in case of emergency? *

In case of sickness or accident, we give permission for medical attention and treatment as deemed needed by healthcare professionals be administered. *

Yes

If you selected 'No' above, please explain so we know best how to help in an emergency. *

Phoenix Children's Chorus

PCC Canto Emergency Contact/Health Info