Permission to Transport

I/We _____________________________ give Pamela Ball my/our permission to take my/our child ________________________ in her vehicle or by foot away from Pam’s Play Place and Preschool. I/We ______________________ understand that my/our child _______________________ will be in a safety-approved car seat as required by Colorado State Law.

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Colorado State Law requires children:

• Younger than 1 year and less than 20lbs. be in a rear-facing infant seat.
• 1 through 3 years and 20-40 lbs. be in a forward-facing child safety seat.
• 4 through 5 years and less than 55” be in a booster seat.
• 6 through 15 years of age and 55” or more in an adult safety belt

______ ______ Initial

I/We ________________________ may be required to provide a safety-approved car seat, as stated above for my/our child _______________________.

______ ______ Initial

(Mother/Guardian)                                                                    (Date)

(Father/Guardian)                                                                     (Date)

(Pamela Ball)                                                                             (Date)

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