FAMILY EXIT FORM
TO BE COMPLETED WHENEVER: 1.
A CHILD/FAMILY LEAVES YOUR CARE
PLEASE COMPLETE AND RETURN TO THE OFFICE AS SOON AS POSSIBLE SO THAT WE CAN UPDATE OUR COMPUTER RECORDS.
EDUCATOR PARENTS NAME CHILD’S NAME
“ “ “ AS FROM:
……../……./20…..
EXIT I WILL NO LONGER BE ACTING AS EDUCATOR FOR THIS FAMILY
(please tick appropriate box)
FAMILY NO LONGER USING WINDERMERE FAMILY DAY CARE REASON FOR LEAVING ______________________________________ FAMILY DOES NOT CURRENTLY REQUIRE CARE
FAMILY USING DIFFERENT EDUCATOR – NEW EDUCATOR’S NAME ____________________
CURRENT EDUCATOR SIGNATURE ____________________ DATE ________________________
PARENT SIGNATURE ________________________________ DATE ________________________