Diaper Change Liability Waiver

Diaper Change Liability Waiver
Event Date

MonthDayYear
Date
I acknowledge and understand,

In order to provide your child with comfort, their diaper changing/toileting will be checked on an hourly basis.

If your child shows signs of redness etc., you will be notified when you pick your child up.

We will NOT use any creams or ointments on your child unless YOU provide such and give instruction on its use!

Children who are potty trained, recieve a walk to the bathroom. Staff waits outside the stalls (6 & under), or door entrance (7& above).

I (parent/guardian__________________________________ give my permission for the providers of PLAY.ISH LLC to provide diaper changes/ tolieting as needed to my child during the duration of this event.

I, (parent/guardian__________________________________ DO NOT give my permission for the providers of PLAY.ISH LLC to provide diaper changes/ toileting to my child during the duration of this event.

I acknowledge that by NOT extending permissions, I will provide a personal point of contact person to change/assist with diapering when needed.

I acknowledge that by signing this agreement I will provide the necessary items of diapers/ pull-ups/ wipes for my child to be assisted with diapering procedures!
Other information we should know? Redness, Cloth diapers, Diaper allergy, etc.
Point of Contact for Diapering/Tolieting

First NameLast Name
Point of Contact Phone Number
Format: (000) 000-0000.
Parent/ Guardian Name*

First NameLast Name
Parent/Guardian Signature*

Clear
Should be Empty: