Free Childcare Waiver Template
Childcare Waiver
I. Introduction
This Childcare Waiver ("Waiver") is entered into by and between [YOUR CHILDCARE FACILITY NAME], located at [FACILITY ADDRESS], and the undersigned parent or legal guardian ("Parent/Guardian") of the child(ren) enrolled in the childcare services provided by [YOUR CHILDCARE FACILITY NAME].
II. Purpose
The purpose of this Waiver is to release and waive any liability that [YOUR CHILDCARE FACILITY NAME] may have in connection with providing childcare services to the child(ren) named herein.
III. Representation
The Parent/Guardian represents and warrants that they have legal authority to execute this Waiver on behalf of the child(ren) named herein.
IV. Waiver of Liability
In consideration of the childcare services provided by [YOUR CHILDCARE FACILITY NAME], the Parent/Guardian hereby releases, waives, and discharges [YOUR CHILDCARE FACILITY NAME], its officers, employees, and agents from any and all liability, claims, demands, actions, and causes of action arising out of or related to any injury, illness, or harm suffered by the child(ren) while under the care of [YOUR CHILDCARE FACILITY NAME].
V. Emergency Medical Treatment
The Parent/Guardian authorizes [YOUR CHILDCARE FACILITY NAME] to seek emergency medical treatment for the child(ren) named herein in the event of an emergency where such treatment is deemed necessary by [YOUR CHILDCARE FACILITY NAME] staff. The Parent/Guardian agrees to be responsible for any costs associated with such emergency medical treatment.
VI. Acknowledgment of Understanding
The Parent/Guardian acknowledges that they have carefully read and fully understand the terms and conditions of this Waiver. The Parent/Guardian acknowledges that they are signing this Waiver voluntarily and without any duress or coercion.
VII. Child's Information
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Child's Name: [CHILD NAME]
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Date of Birth: [DATE OF BIRTH]
VIII. Emergency Contact Information
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Emergency Contact Name: [NAME]
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Relationship to Child: [RELATIONSHIP TO CHILD]
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Phone Number: [PHONE NUMBER]
IX. Signature
By signing below, the Parent/Guardian acknowledges that they have read, understood, and voluntarily agree to the terms and conditions of this Childcare Waiver.
Guardian Signature
[GUARDIAN NAME]
[DATE]
