JOYFUL NOISE Summer of Fun, Exploration and ... - Community Spice

BASIC INFORMATION:Child’s Primary Language ____________________________________________________Child’s Nickname ___________________________________________________________Are there any health problems of which the staff should be aware? _____ YES_____NOIf yes, please explain: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Are there any allergies of which the staff should be aware? _____ YES _____NOIf yes, please explain: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Please add any comments that might further the understanding of your child:_________________________________________________________________________________________________________________________________________________________________________________________________________*****************************************_____ I give permission for my child to participate in walking trips within the neighborhood._____ I do not give permission for my child to participate in walking trips within the neighborhood.*****************************************Please indicate below person(s) (other than the parent/guardian) authorized to visit or take your child from the center.1) _____________________________________________________________________2) _____________________________________________________________________3) _____________________________________________________________________4) _____________________________________________________________________5) _____________________________________________________________________Parent/Guardian Signature ________________________________________________________ Date _______________