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Ibuprofen Tylenol Cough Drops Benadryl Antibiotic Ointment Midol Other Special Instructions By signing this document I give permission for Dayspring Christian Academy school staff to administer OTC over the counter medication to the above named child. Request for Medication Administration 2016-2017 School Year The parent/guardian of requests that Dayspring Child s name Christian Academy staff administer the medications selected below as needed. It is the parent/guardian s responsibility...
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Read the instructions on the form carefully
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Gather all the necessary information and documents
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Provide accurate personal details of the parent or guardian
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Fill in the requested information for the child or ward
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Who needs form parentguardian of requests?

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Parents or guardians who need to request services for their child or ward
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Individuals responsible for legal decisions on behalf of a child
03
Relatives or caregivers tasked with providing consent for activities or medical treatment
04
Educators or school administrators requesting special accommodations for students
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It is a form used to request permission or approval from a parent or guardian for certain activities or decisions.
Minors or individuals under the legal age who need parental or guardian consent.
The form typically requires basic information about the minor, details of the request, and signatures from both the minor and parent or guardian.
The purpose is to ensure that minors have proper authorization for activities that require parental consent.
The form may require details of the activity or decision requiring consent, contact information of the minor and parent/guardian, and signatures.
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