PERMISSION TO PARTICIPATE IN DAY CARE ACTIVITIES

AND TO RECEIVE MEDICAL CARE

I hereby grant permission for my child to use all the play equipment and participate in all
the activities of the Day Care.

Signature: ____________________________________________________

I hereby grant permission for my child to leave the Day Care premises under the
supervision of a staff member for neighborhood walks arranged outings.

Signature: ____________________________________________________

I hereby grant my child to be included in evaluations and pictures connected with the
program.

Signature: ____________________________________________________

If in the event of sudden illness or accident to my child, and I am not available to consent
to treatment, I hereby give permission to the Director or designate of Toddle Inn Day
Care Center to obtain emergency medical treatment and or receive emergency First Aid
Treatment.

Signature: ____________________________________________________

I hereby acknowledge receipt of a copy of the Day Care Parent Information Package. I
have read, understood and agree with the information in the complete child care
registration process.

Date:

Signature

Co – Applicant
(husband/partner)

Witness