Name of child: Juanita LopezDate of birth: 23rd September 2000
Emergency contact details
Contact person 1
Surname: LopezFirst name/s: EmmanuelAddress: Unit 2/364 Breaker Drive Joondalup 6027Home telephone: 9555 2121Work telephone: N/APlace of work/study: N/AHours usually available: Any timeRelationship to the child: GrandfatherSignature of above person sighted by Cybertots staff member? Yes
Contact person 2
Surname: AndersonFirst name/s: AlisonAddress: 29 Grand Promenade Morley 6062Home telephone: 9375 9884Work telephone: N/APlace of work/study: Home dutiesHours usually available: Any timeRelationship to the child: Family friendSignature of above person sighted by Cybertots staff member?