Monthly Individual Child Sign-In & Sign-Out Form

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Monthly Individual Child Sign-In & Sign-Out Form
Child’s Name: ___________________________________________________________________
Month & Year: ______/______
Date
Time In
Parent Signature
Time Out
Parent Signature
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This form is provided for technical assistance purposes only. Providers may use this form if they choose, but are not required to use this form.
Monthly Sign-in & Sign-Out
DOH/BCCL 8/08

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