| SUNSCREEN/LOTIONS PERMISSION FORM I give provider, Michelle Gengenbacher, owner of COLOR ME HAPPY DAYCARE, permission to apply sunscreen, lotions, diaper rash medicine, orajel, etc. to our child. Taking into consideration that some children�s skin is more sensitive, we will provide the provider, Michelle, with the product we want applied to our child. Our childs name will be wrote with permanent marker on the product and left at Michelle�s home, to be applied as needed. I understand that this form is valid the entire time my child is in the care of this provider. I understand that it is my responsibility to contact my provider for a new form should I wish to change this information. Child�s Name__________________________________Date of Birth______________ Diaper Wipes ( ) yes ( ) no Brand________________________________________ Diapering Ointments ( ) yes ( ) no Brand__________________________________ First Aid Ointments ( ) yes ( ) no Brand___________________________________ Baby Lotions ( ) yes ( ) no Brand________________________________________ Insect Spray ( ) yes ( ) no Brand_________________________________________ Sunscreen ( ) yes ( ) no Brand___________________________________________ Tylenol ( ) yes ( ) no Brand_____________________________________________ Other___________________________________________________________________ ________________________________________________________________________ ___________________________________________________________________ Mother�s Signature_________________________________________Date__________ Father�s Signature__________________________________________Date__________ |
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