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: ________________________________________________________

Please take a moment to sign my guestbook. I'd love to hear from you.