X____ This form is stating that I _____________________________ will not hold.
Melissa Winegardner responsible legally or otherwise for any accident that may so
occur under her care. This means any thing that is beyond her control or not do to
negligence, unsafe situation presented to my child, or pure inability to preform sitting
tasks. I also acknowledge that if such incident occurs my child will receive immediate
care through Melissa Winegardner on my behalf.
X_____ I Understand that if any suspect of abuse on my behalf or behalf or family or
friends associated with myself. I will first verbally be notified. Than through writing.
Finally through proper authorities. This will be done in the best interest of my child.
X_____I will provide my child's insurance card to be copied, and all papers given by
Melissa Winegardner at beginning
Answer by lilbit022009 at 12:15 PM on Aug. 12, 2009
Answer by lilbit022009 at 12:11 PM on Aug. 12, 2009
Answer by hot-mama86 at 12:24 PM on Aug. 12, 2009
Answer by Anonymous at 12:38 PM on Aug. 12, 2009
Answer by hot-mama86 at 12:45 PM on Aug. 12, 2009
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