Free Day Care Authorization Form Template

Day Care Authorization Form

Please complete the following form to authorize [Your Company Name] to care for your child.

Parent/Guardian Information

Name

    Email

    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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