Fillable FOR CHILD CARE PERMISSION TO PARTICIPATE IN SWIMMING (Muskingum College)

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FOR CHILD CARE PERMISSION TO PARTICIPATE IN SWIMMING (Muskingum College)

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Ohio Department of Job and Family Services
PERMISSION TO PARTICIPATE IN SWIMMING ACTIVITIES
FOR CHILD CARE
JFS 01227 (Rev. 12/2016)
Written parental permission is required for the water activities your child will be engaging in (check all that apply for
this activity)
Child swimming in water 18 inches or more in depth
Child participating in activities near water 18 inches or more in depth (no water activities planned)
Infants and toddlers using wading pools
I give permission for my child to participate in the following swimming/water activities
Swim Site
Date(s)
Departure/Arrival Times from Center
Mode of Transportation (parent's driving, provider vehicle, public transportation, school bus, etc.)
Child's Name
Child's Date of Birth
My child is a Swimmer Non swimmer
Parent's Signature
Date
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FOR CHILD CARE PERMISSION TO PARTICIPATE IN SWIMMING (Muskingum College)

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Completed 20 April 2021

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