ContractEnrollment Agreement • October 25th, 2022
Contract Type FiledOctober 25th, 2022AGREEMENTI consent to the enrollment of the child listed above in this facility and have been advised of the policies regarding administration of medication, fees, transportation and the services provided by the facility and the Office of Children and Family Services regulations. I give consent for this child to take part in field trips or excursions away from the facility under proper supervision.I agree that in the case of accident or injury, emergency medical care may be given in the event the person(s) designated above cannot be reached.I have provided special information on my child's special needs (medications, allergies, diet, medical information) to assist the facility in caring for this child.I agree to review and update this information whenever a change occurs and/or at least every six months. SIGNATURE OF PARENT OR PERSON(S) LEGALLY RESPONSIBLE DATE FOR OFFICE USE ONLY DATE ILLNESS ACCIDENT (describe injuries)
ContractEnrollment Agreement • November 30th, 2021
Contract Type FiledNovember 30th, 2021AGREEMENTI consent to the enrollment of the child listed above in this facility and have been advised of the policies regarding administration of medication, fees, transportation and the services provided by the facility and the Office of Children and Family Services regulations. I give consent for this child to take part in field trips or excursions away from the facility under proper supervision.I agree that in the case of accident or injury, emergency medical care may be given in the event the person(s) designated above cannot be reached.I have provided special information on my child's special needs (medications, allergies, diet, medical information) to assist the facility in caring for this child.I agree to review and update this information whenever a change occurs and/or at least every six months. SIGNATURE OF PARENT OR PERSON(S) LEGALLY RESPONSIBLE DATE FOR OFFICE USE ONLY DATE ILLNESS ACCIDENT (describe injuries)