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Trampoline Use Permission

Use of a trampoline by children in care should only occur when the following conditions are met: 1) The trampoline is well maintained and in good condition, and there is clearance of at least 5 feet around the edge, or there is a safety cage net. 2) An adult is present to directly supervise use. 3) Only one child at a time on the trampoline. 4) Children should be instructed to restrict their jumping to the middle of the trampoline bed. I have read the requirements for the use of a trampoline in my provider's child care home. I give permission for my child(ren), , to use the trampoline in this child care home. Parent/Guardian signature_________________________________ Date_____________

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Trampoline Use Permission

Use of a trampoline by children in care should only occur when the following conditions are met: 5) The trampoline is well maintained and in good condition, and there is clearance of at least 5 feet around the edge, or there is a safety cage net. 6) An adult is present to directly supervise use. 7) Only one child at a time on the trampoline. 8) Children should be instructed to restrict their jumping to the middle of the trampoline bed. I have read the requirements for the use of a trampoline in my provider's child care home. I give permission for my child(ren), , to use the trampoline in this child care home. Parent/Guardian signature_________________________________ Date_____________

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Trampoline Use Permission

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