Parent Agreement & Authorization Form

Parent Name:

Parents Email:

Child Name:

Child DOB:

As the parent or legal guardian of the above named child, I agree to the following:

I understand That the State law requires Children’s Immunizations to be up to Date AT ALL TIME.

I will be notify to Gina’s Childcare every update with my Child.

I agree to follow all health policies and to inform Gina’s Childcare of any Contagious Illness.

I agree to bring my child according to my contracted hours and days.

I agree to report my child absence or late arrival.

I understand fees are due every day my child schedule to attend Gina’s Childcare, including days of absences due to illness or vacation.

I understand that children may not be brought to the program after 10:00 a.m.

I understand a need to give two weeks’ notice before living Gina’s Childcare Or I HAVE TO PAY 3 WEEKS.

Any Disturbances at Gina’s Childcare will result in termination of services

I authorize and give permission for all of the following for my child: *Permission for my child to appear in photographs or video in www.gigischildcare.com
• Participate in walks in the neighborhood.

Agree to this day of:

Parent Signature:

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