| Permission & Consent Form For: Allison Piper, Pipers Playhouse Yes No Initial To administer over the counter type medications (supplied by parent) ____ ___ ____ Use my vehicle with proper restraints within Durham Region ____ ___ ____ To go for walks in the neighbourhood ____ ___ ____ To go swimming in our kiddie pool ____ ___ ____ To take photos and display art work (photos may be displayed on our website) ____ ___ ____ To give an occasional candy treat ____ ___ ____ To assist with toilet training procedures ____ ___ ____ To give my telephone number to other parents (for references only) ____ ___ ____ To pick up from school (Woodcrest P.S.) ____ ___ ____ To go to the Ontario Early Years Center _____ ____ _____ To go to parks in Durham Region _____ _____ _____ Parent's Signature:__________________________________________ Date: _____________________________ |
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