PERMISSION TO TAKE CHILD ON TRIPS OR OUTINGS
(MODEL FORM)
I, __________________________________, give _____________________________
(parent’s signature)
(child’s name)
permission to go to ________________________________________________________
(destination / address)
with ______________________________________ leaving on ___________________
(provider’s name)
(time and date)
and returning _____________________________. Please return this authorization form
(time and date)
to the family day care provider to allow your child to participate in the trip or outing.
PERMISSION TO TAKE CHILD ON TRIPS OR OUTINGS
I, __________________________________, give _____________________________
(parent’s signature)
(child’s name)
permission to go to ________________________________________________________
(destination / address)
with ______________________________________ leaving on ___________________
(provider’s name)
(time and date)
and returning _____________________________. Please return this authorization form
(time and date)
to the family day care provider to allow your child to participate in the trip or outing.
COMMONWEALTH OF VIRGINIA
DEPARTMENT OF SOCIAL SERVICES
032-05-047 (9/93)
PERMISSION TO TAKE CHILD ON TRIPS OR OUTINGS
(MODEL FORM)
I, __________________________________, give _____________________________
(parent’s signature)
(child’s name)
permission to go to ________________________________________________________
(destination / address)
with ______________________________________ leaving on ___________________
(provider’s name)
(time and date)
and returning _____________________________. Please return this authorization form
(time and date)
to the family day care provider to allow your child to participate in the trip or outing.
PERMISSION TO TAKE CHILD ON TRIPS OR OUTINGS
I, __________________________________, give _____________________________
(parent’s signature)
(child’s name)
permission to go to ________________________________________________________
(destination / address)
with ______________________________________ leaving on ___________________
(provider’s name)
(time and date)
and returning _____________________________. Please return this authorization form
(time and date)
to the family day care provider to allow your child to participate in the trip or outing.
COMMONWEALTH OF VIRGINIA
DEPARTMENT OF SOCIAL SERVICES
032-05-047 (9/93)
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