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KidZone Hourly Playcare - Medication Authorization

Kidzone requires parental consent for any child requiring medication, including epipens or
inhalers, while at the program. Kidzone staff is required to observe and record all use of
medication by a child while attending the program. Please ensure that all medication is in its
original container. Please list one item per sheet with full usage/special instructions.

By signing below you are giving permission for a Kidzone staff member to administer the above
medication to your child according to labeled directions on the original medication container.

SELF ADMINISTRATION OF MEDICATION

In some cases, children are able to administer their own medication. In all cases, program staff
is required to observe children taking medication.