GRAPE DAYCARE


OUTDOORS ACTIVITY PERMISSION FORM

 

I hereby give the provider and staff of THE GOOD CHRISTIAN HOME DAYCARE

 

Permission to take my child_______________________________for short walking trips and on any of the activities checked below as part of the family/group family day care program and promoting our Website. 


             Providers Backyard 

             Walks in the Neighborhood Park 

             Other Neighborhood Walks

             Allow my child to play in water

             Take photographs of my child/children to use in and promoting Daycare on our Website

             Assist my child with any toilet training procedures/problems

 

Parent/Guardian Signature_________________________________________________

 

Telephone number (     ) ___________________________________________________

 

Date:____/____/_______

                                           

 

SLEEPING AND NAPPING ARRANGEMENT

 

I understand that my child____________________________will be napping on a mat/cot/crib in the NAP AREA of the provider’s DAYCARE.

He/she will be supervised.

If my child is an infant, I also understand that my child/children will be placed on his/her back to sleep.

 

Parent/Guardian Signature:______________________________________________

Date:_____/_____/_________

 

 

 PICK-UP AUTHORIZATION

 

I (we) the parent(s) of _________________________________________give my (our) consent for the following individual(s) to pick up my (our) child if I (we) are unable to do so.

1.      __________________________________________

2.      __________________________________________

3.      __________________________________________

4.      __________________________________________

5.      __________________________________________

The following individual(s) are not allowed to pick up my (our) child/children.

1.      ___________________________________________

2.      ___________________________________________

3.      ___________________________________________

4.      ___________________________________________

5.      ___________________________________________

 

 

___________________________________              _______________

Parent(s) Signature                                                                  Date

 

___________________________________              _______________

Provider Signature                                                                  Date

 

 

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