DA Form 5222-R "Child Development Services (Cds) Sponsor Consent Form"

What Is DA Form 5222-R?

This is a military form that was released by the U.S. Department of the Army (DA) on July 1, 1989. The form, often mistakenly referred to as the DD Form 5222-R, is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DA.

Form Details:

  • A 1-page document available for download in PDF;
  • The latest version available from the Army Publishing Directorate;
  • Editable, free, and easy to use;
  • Fill out the form in our online filing application.

Download an up-to-date fillable DA Form 5222-R down below in PDF format or browse hundreds of other DA Forms stored in our online database.

ADVERTISEMENT
ADVERTISEMENT

Download DA Form 5222-R "Child Development Services (Cds) Sponsor Consent Form"

Download PDF

Fill PDF online

Rate (4.6 / 5) 107 votes
CHILD DEVELOPMENT SERVICES(CDS) SPONSOR CONSENT
For use of this form, see AR 608-10; the proponent agency is ACSIM.
I,
parent/guardian of
consent*
to the following in reference to the care of my child/children.
CHECK
YES
NO
USE OF PHOTOGRAPHS FOR RELEASE TO MEDIA
PARTICIPATION IN ON-AND-OFF POST EXCURSIONS ACCOMPANIED BY CDS PERSONNEL
INDEPENDENT PARTICIPATION IN ATHLETIC EVENTS, CLASSES, YOUTH ORGANIZATIONS AND CLUBS, WALKING TO AND FROM
SCHOOL, VISITING FRIENDS, OR OTHER ACTIVITIES LISTED BELOW.
ACTIVITY
LOCATION
DEPART
DAYS
DATES
ARRIVE
CHECK
YES
NO
TRANSPORTATION IN A GOVERNMENT OR COMMERCIAL VEHICLE
TRANSPORTATION IN A PRIVATE VEHICLE
OTHER-
OTHER-
OTHER-
REMARKS
*Sponsor consent for access to emergency medical or dental treatment is contained in DA Form 4719-R. Sponsor consent for
administration of medication is contained on DA Form 5225-R
DATE
SIGNATURE OF SPONSOR
DA FORM 5222-R, JUL 1989
APD LC v3.00ES
CHILD DEVELOPMENT SERVICES(CDS) SPONSOR CONSENT
For use of this form, see AR 608-10; the proponent agency is ACSIM.
I,
parent/guardian of
consent*
to the following in reference to the care of my child/children.
CHECK
YES
NO
USE OF PHOTOGRAPHS FOR RELEASE TO MEDIA
PARTICIPATION IN ON-AND-OFF POST EXCURSIONS ACCOMPANIED BY CDS PERSONNEL
INDEPENDENT PARTICIPATION IN ATHLETIC EVENTS, CLASSES, YOUTH ORGANIZATIONS AND CLUBS, WALKING TO AND FROM
SCHOOL, VISITING FRIENDS, OR OTHER ACTIVITIES LISTED BELOW.
ACTIVITY
LOCATION
DEPART
DAYS
DATES
ARRIVE
CHECK
YES
NO
TRANSPORTATION IN A GOVERNMENT OR COMMERCIAL VEHICLE
TRANSPORTATION IN A PRIVATE VEHICLE
OTHER-
OTHER-
OTHER-
REMARKS
*Sponsor consent for access to emergency medical or dental treatment is contained in DA Form 4719-R. Sponsor consent for
administration of medication is contained on DA Form 5225-R
DATE
SIGNATURE OF SPONSOR
DA FORM 5222-R, JUL 1989
APD LC v3.00ES