Name of Student *

First Name

Last Name

Phone Number of Student *

(###)

###

####

Name of Contact *

First Name

Last Name

Phone Number of Contact *

(###)

###

####

Agreement of Responsibility *

Select "I understand and agree", I, the student named above, understand that I am solely responsible for the accuracy of the information contained herein and for updating this information as needed.

I understand and agree

Agreement of Understanding *

As a resident of Boston Baptist College student housing, I understand that the information supplied on this form is to be utilizes for the purpose of effectuating investigation concerns that I am a missing person. I understand that the information contained on this form may be used in addition to the emergency contact information I supplied on my Boston Baptist College Enrollment Application. I expressly give my permission for this contact information to be released by Boston Baptist College to law enforcement agencies for the purpose of investigation, whether I may be missing and to effectuate a missing person’s report and missing person investigation as needed.

I understand and agree

I decline to give permission for the emergency contact information to be released for this purpose. If you permit the release of this emergency contact information for this purpose, please do NOT check off the box below. Only students currently over 18 years of age may decline.

I decline permission