Napping Agreement PARENT – CHILD CARE PROVIDER NAPPING AGREEMENTParent's Name Child´s Name I , agree to have my child , parent’s name child’s name nap in/on a mat, cot, crib, pack and play, or bed (circle one) , which will be placed in the playroo I give permission for my child care provider to use an electronicmonitor as an indirect means of supervision while my child isnapping. I understand that my child care provider must leave the doors open to all rooms where children are napping. I understand that electronic monitors will be used as an alternate means of supervision only when my child is napping. I do not want my provider to use an electronic monitor as an indirect means of supervision. I want my child care provider to directlysupervise my child during nap time. I understand that my child care provider must remain on the same level of the home as the children at all times. Sleeping arrangements for infants require that the infant be placed on his or her back to sleep, unless medical information is presented to the provider by the parent that shows that this arrangement is inappropriate for that child.I , agree to have my child , parent’s name child’s name nap in/onChoose Mat Cot Crib Pack and play Bed Which will be placed in the Playroom Bedroom Living room Dining room Other Specify I give permission for my child care provider to use an electronic monitor as an indirect means of supervision while my child is napping. I understand that my child care provider must leave the doors open to all rooms where children are napping. I understand that electronic monitors will be used as an alternate means of supervision only when my child is napping. I do not want my provider to use an electronic monitor as an indirect means of supervision. I want my child care provider to directly supervise my child during nap time I understand that my child care provider must remain on the same level of the home as the children at all times. Sleeping arrangements for infants require that the infant be placed on his or her back to sleep, unless medical information is presented to the provider by the parent that shows that this arrangement is inappropriate for that child.Parent’s signatureDate MM slash DD slash YYYY Provider’s SignatureDate MM slash DD slash YYYY Developed by Child Development CouncilLast Revised 4/2009
