undefined
HomeAll templateschildcare formschildcare authorization form

Childcare Authorization Form

This form is used to authorize someone else to provide child care for your child. This form is typically used when the child is going to be in the care of another person or organization, such as a babysitter, daycare, or camp. This form is used to give the caregiver permission to provide care for the child, as well as permission to take the child to the doctor or hospital if necessary.

3 minutes to complete

Eligibility

To fill out the Childcare Authorization Form, the individual must be a parent or legal guardian of the child who will be receiving childcare services.

undefined

Questions for Childcare Authorization Form

Questions

1.

Child's Name

The answer should be a text input.
2.

Date of Birth

The answer should be a date input.
3.

Age

The answer should be a single choice:
  1. Under 18
  2. 18-24 years old
  3. 25-34 years old
  4. 35-44 years old
  5. 45-54 years old
  6. Over 55
4.

Gender

The answer should be a single choice:
  1. Male
  2. Female
5.

Address

The answer should be a text input.
6.

Nationality

The answer should be a country.
7.

Telephone Number

The answer should be a phone number.
8.

Father's Name

The answer should be a text input.
9.

Profession

The answer should be a text input.
10.

Phone Number

The answer should be a phone number.
11.

Office Address

The answer should be a text input.
12.

Mother's Name

The answer should be a text input.
13.

Profession

The answer should be a text input.
14.

Phone Number

The answer should be a phone number.
15.

Office Address

The answer should be a text input.
16.

Caretaker's Name

The answer should be a text input.
17.

Gender

The answer should be a single choice:
  1. Male
  2. Female
  3. Other
  4. Prefer not to say
18.

Type of childcare service

The answer should be a single choice:
  1. Childcare
  2. Family Day Care
  3. Pre-School or Kindergarten
  4. Nursery School
  5. Casual Child Care Services
  6. In-Home Child Care
  7. Nanny Care
  8. Babysitter
19.

Phone Number

The answer should be a phone number.
20.

Office Address

The answer should be a text input.
21.

I, the undersigned parent or guardian hereby grant the child caretaker the permission to temporarily look after my child.

The answer should be a signature.

Forms Similar to Childcare Authorization Form

  • Daycare Authorization Form
  • Babysitting Authorization Form
  • Nanny Authorization Form
  • Childcare Provider Authorization Form
  • Child Care Authorization Agreement

Here are some FAQs and additional information
on Childcare Authorization Form

What is the childcare authorization form?

The Childcare Authorization Form is a document that parents or guardians can fill out to authorize someone else to take care of their child.

As a parent, can I change the care provider mentioned in the authorization agreement?

Yes. You can assign another person to take responsibility for your child but for more details, contact your lawyer or a legal professional.

What information is required on a Childcare Authorization Form?

The form must usually include the name and contact information of the person or organization providing the childcare services, as well as the name and contact information of the parent or guardian authorizing the childcare arrangement. The form can also include the dates and times during which the childcare arrangement is authorized, and list any specific instructions or limitations on the arrangement.

Why is a Childcare Authorization Form necessary?

A Childcare Authorization Form is necessary to ensure that the person or organization providing childcare services is authorized to do so, and to provide the parent or guardian with a record of the arrangement.

Want to use this template?

Loved by people at home
and at work

undefined
“BlockSurvey is a simple, effective, and scalable tool for creating surveys for leadership and learning assessment. It's one of this year's best buying choices. Each month, it keeps improving and strives to serve its customers needs.”
Nelson Emilio
Personal Branding Strategist
undefined
“I use BlockSurvey to get feedback about all my activities and events. It is really easy to get started and create my first surveys! Then I could see how easy it was to share them. Now I am thinking to use BlockSurvey also within my creative process as an author in order to listen and engage with my audience, knowing that anonymity provides the most sincere and reliable answers.”
Georgina García-Mauriño
Author & Designer
BlockSurvey social proof
G2 Crowd
4.8 Star Rating
BlockSurvey social proof
Dapp.com
Editor's choice
BlockSurvey social proof
Capterra
4.9 Star Rating

What's next? Try out templates like
Childcare Authorization Form

1000+ Templates, 50+ Categories

Explore more
undefined
School Situation Questionnaire
The School Situation Questionnaire is a questionnaire that is used to assess the current state of a student's school life. It helps to identify any potential issues that the student may be facing in the classroom, such as lack of motivation, difficulty focusing, or lack of engagement. 
undefined
State Trait Anxiety Inventory For Children
The State-Trait Anxiety Inventory for Children (STAIC) is a psychological self-report inventory designed to measure a child's level of anxiety. It consists of 40 items that measure two separate aspects of anxiety: state anxiety, a person's current level of anxiety, and trait anxiety, which is a person's overall level of anxiety. 
undefined
CRIES Scale
The CRIES scale is a tool used to assess the degree of pain in infants aged two months or younger.
undefined
Children Manifest Anxiety Scale
Anxiety could lead to manifestations such as tension and nervousness, feelings of helplessness, insecurity and loneliness. This scale measures anxiety in children.
undefined
School Anxiety Scale
The SSAS is intended for children and adolescents aged 8-18. It can be used to assess the level of social anxiety in individuals in an educational setting.
undefined
Childcare Observation Form
This form is used to collect data about a child's behavior in a childcare setting. It can be used to track progress over time, or to identify areas of concern that may need to be addressed.
undefined
Childcare Accident Report Form
A childcare accident report form is used by childcare providers to document and track accidents that occur in their facility. This form is important for documenting the details of an accident, as well as for ensuring that proper safety procedures are followed in the future.
undefined
Childcare Emergency Contact Form
The Childcare Emergency Contact Form is used by childcare providers to collect emergency contact information for the children in their care. This form is used to ensure that the provider has the necessary information to contact the child's parents or guardians in the event of an emergency.
undefined
Childcare Registration Form
The Childcare Registration Form is used by parents or guardians to register their child or children for childcare services.
undefined
Childcare Authorization Form
This form is used to authorize someone else to provide child care for your child. This form is typically used when the child is going to be in the care of another person or organization, such as a babysitter, daycare, or camp. This form is used to give the caregiver permission to provide care for the child, as well as permission to take the child to the doctor or hospital if necessary.
undefined
Childcare Enrollment Form
This Childcare Enrollment form is designed for use by childcare providers to collect information about the child and family. This form will usually ask for your child's personal information, contact information, and medical information.
undefined
Childhood trauma survey
A childhood trauma survey is a tool used to assess an individual's exposure to potentially traumatic events during childhood. The survey can be used to help individuals identify their own exposure to trauma and to seek treatment for any resulting problems.
undefined
Childcare Staff Evaluation Form
The Childcare Staff Evaluation Form is a great way to get feedback from staff members about their experience working with children. This form can be used to evaluate different aspects of the job, such as the staff's interaction with children, and the overall quality of care.

Want to create secure online forms and surveys?

Join BlockSurvey.

SHARE