Sunscreen Permission Form

By signing below, you are permitting a sunscreen product of SPF 15 to be applied to your child’s bare skin surfaces including, but not limited to, the face, tops of the ears, nose, and bare shoulders, when outdoor activities in direct sunlight are scheduled.

Today's Date

MM

DD

YYYY

Child's Name

First Name

Last Name

Child's Date of Birth

MM

DD

YYYY

Does your child have any known allergies to sunscreen products?

Yes

No

If yes, please explain.

Authorized By

When printing your name, you are acknowledging the printed name on these documents will act as your temporary authorization and we will require you to sign the documents in person:

First Name

Last Name

Relationship to Child:

E-Signature

Typing your name in the box below acts as your e-signature.

Signature Date

MM

DD

YYYY

Sunscreen Permission Form

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