GCB Permission FormChild's Name First Last Child's Date of Birth MM slash DD slash YYYY Persons Authorized to pick up my child / children Add RemoveSelect the plus sign on the right to add additional contacts.Persons NOT Authorized to pick up my child / children Add RemoveSelect the plus sign on the right to add additional contacts.Field Trips / Non-Center Activities: I give permission for my child to participate in all activities and field trips that involve my child being transported to or from the Center with the childcare staff.Field Trips Yes NoPhotographs: I give permission for my child to be photographed while participating in Center activities to be used in newsletters, newspapers, and website articles pertaining to the Center and the school.Photographs Yes NoNon-Prescription Topical Medicines: I give permission for my child to have sunscreen, bug spray, etc. applied as necessary while at the Center.Meds Yes NoAccident / Illness Emergency First Aid / Medical Care: I give permission for emergency first aid and/or medical/surgical treatment to be given to my child for accidents or illnesses that may arise while in the care of the Center and will hold staff, Center, and school harmless. Every attempt to contact the parent first, if possible, will be made.Accident Yes NoParent SignatureCAPTCHAΔ
