Hennepin County Child Care Licensing Provider Policies
Please read this document in its entirety
Signatures
I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law. Please see the Consumer Consent Disclosure at https://www.jotform.com/consumer-consent-disclosure/
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Signature
*
Date of Signature
-
Month
-
Day
Year
Date
I have clicked "Preview PDF" and reviewed my form for accuracy
*
Yes
No
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*
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