Form DHS-7749C-ENG "Wading Pool Permission Form" - Minnesota

What Is Form DHS-7749C-ENG?

This is a legal form that was released by the Minnesota Department of Human Services - a government authority operating within Minnesota. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2018;
  • The latest edition provided by the Minnesota Department of Human Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form DHS-7749C-ENG by clicking the link below or browse more documents and templates provided by the Minnesota Department of Human Services.

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Download Form DHS-7749C-ENG "Wading Pool Permission Form" - Minnesota

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DHS-7749C-ENG
Wading Pool Permission Form
Family Child Care
Dear Parent or Legal Guardian:
The 2002 Minnesota Legislature passed a bill that allows portable wading pools to be used by family and group
family child care providers when certain requirements are met. These requirements are specified in
Minnesota
Statutes, section 245A.14, subdivision 10.
A portable wading pool is defined as a pool with a maximum depth of 24 inches that is capable of being
manually emptied and moved. These portable wading pools may only be used after:
1. The parent or legal guardian of the child has provided written consent to the license holder that specifies that
the provider agrees to comply with all the requirements in
Minnesota Statutes, section 245A.14, subdivision
10;
and
2. The written consent includes a statement that the parent or legal guardian has received and read the
document written by the Department of Human Services and the Department of Health titled: “Wading Pool
Risks.”
Please read the Wading Pool Risks form, and decide whether or not to permit your child(ren) to use a wading
pool while under the care of your family child care provider.
If you have questions about the changes regarding wading pools, please contact your local public health
department or the Minnesota Department of Health. If you have questions about child care licensing you
should contact your local county Social Services Agency, or you may call the Minnesota Department of Human
Services.
After completion, please give this form to your child care provider. Your child care provider will be monitored for
compliance with these requirements, and this form will document your decision.
By signing this form, I am acknowledging that I have read the document written by the Department of Human
Services and the Department of Health titled: “Wading Pool Risks.” I have been given the opportunity to talk
with my child care provider about the use of a wading pool, and I understand the risks associated with the use of
a wading pool by my child(ren) while they receive child care services.
_______ I do consent to my child care provider’s use of a wading pool with my child(ren).
_______ I do not consent to my child care provider’s use of a wading pool with my child(ren).
_____________________________________________________________________________
Name of Child(ren)
____________________________
_______________________________
Parent Signature and Date
Provider Signature and Date
6/2018
DHS-7749C-ENG
Wading Pool Permission Form
Family Child Care
Dear Parent or Legal Guardian:
The 2002 Minnesota Legislature passed a bill that allows portable wading pools to be used by family and group
family child care providers when certain requirements are met. These requirements are specified in
Minnesota
Statutes, section 245A.14, subdivision 10.
A portable wading pool is defined as a pool with a maximum depth of 24 inches that is capable of being
manually emptied and moved. These portable wading pools may only be used after:
1. The parent or legal guardian of the child has provided written consent to the license holder that specifies that
the provider agrees to comply with all the requirements in
Minnesota Statutes, section 245A.14, subdivision
10;
and
2. The written consent includes a statement that the parent or legal guardian has received and read the
document written by the Department of Human Services and the Department of Health titled: “Wading Pool
Risks.”
Please read the Wading Pool Risks form, and decide whether or not to permit your child(ren) to use a wading
pool while under the care of your family child care provider.
If you have questions about the changes regarding wading pools, please contact your local public health
department or the Minnesota Department of Health. If you have questions about child care licensing you
should contact your local county Social Services Agency, or you may call the Minnesota Department of Human
Services.
After completion, please give this form to your child care provider. Your child care provider will be monitored for
compliance with these requirements, and this form will document your decision.
By signing this form, I am acknowledging that I have read the document written by the Department of Human
Services and the Department of Health titled: “Wading Pool Risks.” I have been given the opportunity to talk
with my child care provider about the use of a wading pool, and I understand the risks associated with the use of
a wading pool by my child(ren) while they receive child care services.
_______ I do consent to my child care provider’s use of a wading pool with my child(ren).
_______ I do not consent to my child care provider’s use of a wading pool with my child(ren).
_____________________________________________________________________________
Name of Child(ren)
____________________________
_______________________________
Parent Signature and Date
Provider Signature and Date
6/2018