Day Care Authorization Form
Day Care Authorization Form
Please complete the following form to authorize [Your Company Name] to care for your child.
Parent/Guardian Information
Name
Please provide your email address.
Phone Number
Child's Information
Name
Date of Birth
Allergies/Medical Needs
Emergency Contact (if different from above)
Name
Relationship to Child
Phone number
Authorization
I, the undersigned, authorize [Your Company Name] to care for my child during the agreed-upon hours and to seek medical attention if required in an emergency.
Name:
Date:
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