Krebss Home Child Care

Consent Form

Childs Name: ___________________________________

Birth Date: __________________________

CONSENT TO EMERGENCY MEDICAL TREATMENT In the event of an emergency when I cannot be reached, I authorize the administration of any medical procedures deemed necessary by my doctor, or if unavailable, by any other physician selected by my caregiver. Angela Krebss, of Krebss Home Child Care. Parent/Caregiver Signature: ____________________________________________________________ Date: ___________________ ................................................................................................................................ TRANSPORTATION CONSENT FORM I hereby give Angela Krebss, of Krebss Home Child Care permission to take my child, ___________________________________, on field trips or other outings using a car, bus, train or on foot. I understand that all trips taken by means of a car, bus, or train will be discussed a minimum of two weeks in advance, and my written consent must be given for each specific outing. Parent/Caregiver Signature: ____________________________________________________________ Date: ___________________ ................................................................................................................................

Krebss Home Child Care

MEDIA/PHOTO CONSENT AND RELEASE FORM Childs Name: ___________________________________ Birth Date: __________________________

We would appreciate it if parents completed this consent form in order to allow their children to be photographed during special events or normal day to day activities. In order for a child to have their photograph taken, they must have a consent form on file at Krebss Home Child Care. If you do not want to have your child photographed, please do not hesitate to indicate this in the section below. ****** I agree and understand that my child(ren), whose name(s) are listed above, may be photographed at Krebss Home Child Care during normal child care, field trips, or activities. And that I will receive electronic copies of all photos taken of my child while in attendance at Krebss Home Child Care. I understand that these photographs may be used within our facility, in the daycare rooms or in the daycares photo album. And that no photo of your child will be used for commercial or other purposes without your written permission.

( ) Yes, I confirm that I have read and understood the above, and agree to have my child (rens) photos taken for the purposes stated above. Parent/Caregiver Signature: ____________________________________________ Date: ___________________

( ) No, I do not wish to have my child (ren) photographed. Parent/Caregiver Signature: ____________________________________________ Date: ___________________