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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
YES
NO

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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