Child Care Authorization Form

Please complete this Child Care Authorization Form Template to grant permission for caregivers to make important decisions regarding your child's care.

Name of Guardian

Address

Child Care Provider's Information

Name

Date of Beginning

Date of End

This Child Care Authorization form will serve as a legal and binding document that grants the child care provider the authority to:

To pick the children up from school or daycare
Authorize medical treatment or medical procedures for emergency
To provide food and housing for the children
To make decisions regarding daily activities

I give temporary authority of my child to child care provider.

Date: Date

Authorization Form Templates @ Template.net

Thank you for completing this form!

If you have any questions, please contact [Company Email Address].

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