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Permission & Concent Form
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Permission & Concent Form

I would like to request permission to do the following items with/for your child.

Permission Requested for

Parents Initials

To administer over the counter type medications
To transport in my private vehicle with proper child restraint within the Durham Region
To go for walks around neighborhood

To go swimming in our back yard kiddie pools


To take photos


To give an occasional candy treat


To assist with toilet training procedures


Parent's Signature: _____________________________________________

Date: ________________________________________________________

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