Sunscreen/Bug Repellent Permission Slip




If you would like for us to apply Sunscreen/Bug Repellent to your child, please provide us with 
an unexpired bottle of Sunscreen/But Repellent, labeled with your child’s name.  As with any 
topical medication or cream, the first application of any brand of Sunscreen/Bug Repellent 
should be applied at home n order to evaluate your child’s possible allergic reaction to that 
product.

I, ___________________________________ (print name)   give Super Kids’ Place’s staff 
permission to apply the provided Sunscreen/Bug Repellent.

_________________________                                      ___________________________
          Child’s name                                                        Parent’s Signature

_________________________                                        _____________________________
          Child’s name                                                                Date

Annual Updates:  Parent’s Initials and Date
____  ____                ____  ____                     ____  ____                 ____  ____                    
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