Outdoor Consent Form

Outdoor Consent Form

I give Jaymi Greenlee and/or Alexis Kisgen permission to take my child(ren) ___________________________________________

&

___________________________________________

 

to the fenced in mini-park across the parking lot from the day care facility, if weather permits.

 

My child(ren) can use (please circle)

Ÿ       Swings

Ÿ       Slide

Ÿ       Ride on Cars

Ÿ       Monkey Bars

 

My child(ren) cannot use

Ÿ       Swings

Ÿ       Slide

Ÿ       Ride on Cars

Ÿ       Monkey Bars

Reason:________________________________________________________________________________________________________________________________________________________________________________.

 

I will not hold my childcare provider responsible for any injuries that may occur while my child(ren) are in my provider’s care as long as he/she is supervised and the toy(s) are in good condition. Also, I will not hold my childcare provider responsible for the condition of the swings, slide or monkey bars.

 

_____________________________                              _______________

Parent’s Signature                                                     Date

 

**This consent form valid for 6 months after date signed.