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Parent's Notice

State Form 49444 (R / 1-09) / BCC 0035

I understand that this day care ministry is not licensed under the laws of Indiana. However, I understand that this day care ministry complies with the State rules concerning sanitation and fire safety for the primary use of the structure in which is is conducted. I understand that it is my responsibility to ensure that the nutritional and health needs of my child are met while my child is at the day care ministry.

Signature of Parent or Guardianyour full name
Name(s) of children enrolledyour full name

This notice does not absolve a day care ministry from liability for injury to a child while the child is at the day care ministry if the cause of the injury is negligence or intentional wrongdoing on the part of the day care ministry or an employee of the day care ministry


NAME OF FACILITY: First English Lutheran Preschool

ADDRESS OF FACILITY: 16495 Ireland Rd. Mishawaka, IN 46544

COUNTY: St. Joseph

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