ST. GABRIEL CHILD CARE
PARENT PERMISSION FOR
AFTER SCHOOL ACTIVITIES ON THE
PREMISES
Date
________________________
I
request that my child, __________________________________, leave the After
School Care (ASC) to participate in the following
List activity (one activity per sheet): _________________________________________
Days child will leave the ASC: _________________________________________
(Any changes must be sent in writing)
Time activity begins: _________________________________________________
Time activity ends: _________________________________________
____My child is allowed to make the decision not to attend this activity each week.
____My child must attend this activity each week.
*You must check one of the
following:
____I request that my child return to the ASC after attending the above listed activity. My child may return unchaperoned and must report to the on-site director upon his/her return to the center.
____I
request that my child return to the ASC after attending the above listed
activity. My child must return
chaperoned, and it is my responsibility to make the necessary arrangements for
his/her return. My child must report to
the on-site director upon his/her return to the center.
____My
child will not return to the ASC after attending the above listed activity.
If there are any changes, the ASC staff must be notified immediately.
This permission form applies to the following
activities: