EMERGENCY CONSENT CARD

Name of Facility: Life Stars Family Childcare

Child’s Name:(Required)
MM slash DD slash YYYY
Address(Required)
Parent’s Name:(Required)
Child’s Doctor:(Required)
MM slash DD slash YYYY

Consent Form

It is the policy of this centre to notify a parent when a child is ill or needs attention. In the event we cannot contact you and we need to get immediate help for your child, we require a signed consent to do so. 1. I give consent for my child to be taken to the nearest emergency medical centre when I cannot be contacted. 2. I give consent for my child to receive medical treatment.
Name of Parent/ Guardian:(Required)
MM slash DD slash YYYY