| Little Steps Childcare Permission to Administer Form Child(ren) Name(s)__________________________________ I hereby give my childcare provider permission to administer the following products according to manufacture instructions or as specified in writing by my Childs physician. I further understand that I must supply any and all products for my child(ren) with their name on the items. ___Yes ___No Baby Lotion/Moisturizing Lotion ___Yes ___No Baby Powder ___Yes ___No First Aid Cream ___Yes ___No Insect Repellent ___Yes ___No Diaper Rash Ointment ___Yes ___No Sunscreen ___Yes ___No Teething Ointment Parent/Guardian Signature _______________________________________________ Parent/Guardian Signature _______________________________________________ Date___________________ |
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