SUPERVISION OF SCHOOL AGE CHILDREN



SUPERVISION OF SCHOOL AGE CHILDREN

(NOTE: A school-aged child is defined in NYS Regulations as a child enrolled in Kindergarten or a grade higher)

I , give ,

parent’s name child care provider’s name

permission to allow my school age child to play

child’s name

outside the provider’s direct supervision. I understand that my child must

remain on the property and my child care provider will physically check on

my child every 15 minutes.

Parent’s Signature Date _______________

Provider’s Signature __________________________________ Date _______________

SUPERVISION OF SCHOOL AGE CHILDREN

(NOTE: A school-aged child is defined in NYS Regulations as a child enrolled in Kindergarten or a grade higher)

I , give ,

parent’s name child care provider’s name

permission to allow my school age child to play

child’s name

outside the provider’s direct supervision. I understand that my child must

remain on the property and my child care provider will physically check on

my child every 15 minutes.

Parent’s Signature Date _______________

Provider’s Signature __________________________________ Date _______________

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