Routine Trip Enrollment

ROUTINE TRIP PERMISSION FOR CHILD CARE

Ohio Department of Job and Family Services

Routine Trip Destination(s)

Date of Permission (valid for one year)

Mode of Transportation (walking, school bus, public transportation, parent vehicles, provider vehicle and driver)

During this trip children will have access to water that is 18 inches or more in depth.

Yes No

Are water activities planned in water that is 18 inches or more in depth?

(if yes, a swimming permission slip is required)

Yes No

Child's Name

My child is

not over 4 years and/or 40 lbs over 4 years and 40 lbs 8 years and/or over 4' 9"

I grant permission for my child to participate in the routine trips described above.

Parent's Signature

Date