PERMISSION TO RELEASE INFORMATION
Diana's Lil' Darlings Family Home Childcare
Where Children Come First
I understand that during the time my child, _________________________ is in care at Diana's Lil' Darlings Family Child Care, that the child care provider may be asked for information regarding my child.
I hereby give permission to release information to other, official persons only, who identify themselves, such as schools, health care personnel, welfare or other government officials.
Signature of parent/guardian ______________________________________
I do not give my permission to release information about my child as set forth in the aforementioned statement.
I do realize that the Bureau of Services for Child Care has access to my child's records as the licensing agent, and that they will ask for these records on regular visits to the facility.
Signature of parent/guardian ________________________________________________
