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Other Names: Day Care Consent Form
Day Care Authorization Form document preview

What is a Day Care Authorization Form?

Finding the right day care provider for your child is important; so is making sure that they have the right information about your child. With a Day Care Authorization Form you can give your provider the necessary details, like phone numbers and medication. A Day Care Authorization Form helps keep you organized. 
A Day Care Authorization Form can help you make sure the provider has all the crucial information to keep your child safe, as well as specifying the hours of child care, and how much it will cost. A Day Care Authorization Form is particularly handy if you're organizing temporary day care for your kid(s). If you haven't used the temporary provider before, the Day Care Authorization Form is an efficient way of providing all the pertinent information that they will need to know.

When to use a Day Care Authorization Form:

  • You need to give important information about your child to a provider in writing.
  • You want to spell out details of the arrangement.

Sample Day Care Authorization Form

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Day Care Authorization


, the undersigned of , , and , the undersigned child care provider of , , , agree to the following terms regarding the child care of .


The days and hours that will provide care are from to .


Contact Information:




Place of Employment:

Home Phone Number:

Work Phone Number:

Mobile Phone:


If the cannot be reached, contact:





Phone Number:

Relationship to child(ren):


* participation by child(ren) in field trips via walking or riding in the day care provider's vehicle.





By: Date:



Child Care Provider:



By: Date:

give permission to to administer medication to child(ren) as listed below.

Other medical information:

Day Care Authorization Form document preview

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