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Get Filled Form Of Student Dcf Fill Online Printable Fillable

DEPARTMENT OF CHILDREN AND FAMILIES Division of Early Care and Education http //dcf.wisconsin.gov ALTERNATE ARRIVAL / RELEASE AGREEMENT CHILD CARE CENTERS Use of form This form is voluntary. However this completed form when on file in the child s record meets the requirements of DCF 250. 04 6 a 3. and DCF 251. 04 6 a 5. and 251. 095 4 a 2. Personal information you provide may be used for secondary purposes Privacy Law s. If the center transports the child the department s form Transportation Permission Child Care Centers may be used to obtain parental authorization. ARRIVAL INSTRUCTIONS My child Child s name will arrive at Name of center from School home or other activity by way of Walking bicycle bus car pool etc. Be as specific as possible. at A. M. OR P. M. Time of arrival on Sunday Monday My child will arrive from this destination Tuesday with OR Wednesday Thursday Days of the week Friday Saturday without center supervision. RELEASE INSTRUCTIONS will leave to go to Time of departure My child will travel to this destination ADDITIONAL INSTRUCTIONS I understand that I am responsible for notifying the center of any changes in this schedule such as vacation school conference days etc. SIGNATURE Parent DCF-F-CFS104-E R. 09/2009 Date Signed mm/dd/yyyy. 15. 04 1 m Wisconsin Statutes. Instructions Complete this form for placement in the child s file when the child will arrive at the center from school home or other activities or depart from the center to go to school home or other activities and the child will not be accompanied by a parent or other previously authorized person or transported by the center. This form should be updated as information changes. Periodic review with the parent / guardian is recommended to ensure safety. If the center transports the child the department s form Transportation Permission Child Care Centers may be used to obtain parental authorization. ARRIVAL INSTRUCTIONS My child Child s name will arrive at Name of center from School home or other activity by way of Walking bicycle bus car pool etc. Be as specific as possible. DEPARTMENT OF CHILDREN AND FAMILIES Division of Early Care and Education http //dcf*wisconsin*gov ALTERNATE ARRIVAL / RELEASE AGREEMENT CHILD CARE CENTERS Use of form This form is voluntary. However this completed form when on file in the child s record meets the requirements of DCF 250. 04 6 a 3. and DCF 251. 04 6 a 5. and 251. 095 4 a 2. Personal information you provide may be used for secondary purposes Privacy Law s. 15. 04 1 m Wisconsin Statutes. Instructions Complete this form for placement in the child s file when the child will arrive at the center from school home or other activities or depart from the center to go to school home or other activities and the child will not be accompanied by a parent or other previously authorized person or transported by the center. This form should be updated as information changes. Periodic review with the parent / guardian is recommended to ensure safety.

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