Childs name: _________________________________________ Signed: _________________________________________ Date: _________________________________________ Print name: _________________________________________ Relationship to _________________________________________ To be completed by Play Leader/Play Worker Signed: _________________________________________ Date: _________________________________________ name: _________________________________________ Position: __________________________________________ you for completing all sections of this form
Childs name: _________________________________________ Signed: _________________________________________ Date: _________________________________________ Print name: _________________________________________ Relationship to _________________________________________ To be completed by Play Leader/Play Worker Signed: _________________________________________ Date: _________________________________________ name: _________________________________________ Position: __________________________________________ you for completing all sections of this form
breakfast_welcome_pack_sept_2016_1474541246.docx