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Child Name/Nombre del nino
Birth Date/Fecha de cumpleaños
Parent or guardian/ Padre
Child diagnoses/Diagnóstico médico
Allergies/Alergias
Phone number/Nunero de teléfono
Email address/Correo electrónico
Dear parent, In occupational therapy session we from time to time record videos and take pictures of your little chef cooking and learning in the kitchen. In this regard, we seek your consent for the publishing or use of photos which your child may be included. The photos will be used for bulletin boards and/or updates posted via the Facebook, Instagram page, website, and/or within the walls of the daycare premises. For protection of privacy of the child, we guarantee that names will not be included. Please click yes to allow your child to be photographed or videotaped during occupational therapy session. YESNO