General Permission Form

I give Amy Holland permission to administer basic first aid to my child(ren) or in the event of a medical/dental emergency to take steps necessary for the best interest of my child as stated in the Enrollment and Health Information form.

                                                         Initial________                   

I give Amy Holland permission to administer over the counter type medication that I am responsible for providing. (children’s Tylenol, etc)

                                                         Initial________

I give Amy Holland permission to apply lotions/ointments that I am responsible for providing. (diaper rash ointment, powder, sun block, etc.)

                                                          Initial________

I give Amy Holland permission to take my child(ren) on trips in her vehicle or on foot.  The purpose of these trips could be taking/picking up children from school, field trips such as park, library, etc., childcare provider or childcare provider’s children doctor appointments or for an emergency.  All trips will be local.

                                                          Initial________

I give Amy Holland permission to take photos of my child(ren) for the use of displaying the photos in her home showing the childcare activities and to use on letters to parents.

Initial________

I give Amy Holland permission to assist my child(ren) with toilet training.   

                                                          Initial_________

________________________________                      ___________  

Parent/Guardian Signature                                          Date