Директору________________________

                                                                                                                             ^{наименование организации}

   _________________________________

                                                                                                                                                                          ^{ФИО директора}

_________________________________

                                                                                                                                                                                                                                    ^{ФИО родителя}

_________________________________

                                                                                                                                                                                                                                ^{паспортные данные}

Уведомление

Я, _            _________________________________________ настоящим уведомляю о том,                                                                                                                                                                      ^{ФИО родителя (законного представителя)}

   что доверяю   забирать своего ребенка ______________________________________

                                                                                                                                        ^{ФИО ребенка}

______________________________________________ ________________________,

                                                                                                    ^{ФИО                                                                                                      паспортные данные}

___________________________________________________ ___________________,

                                                                                                      ^{ФИО                                                                                                     паспортные данные}

и согласна (согласен)  с тем, что после того, как ребенок покинет здание детского сада с любым из лиц, указанных выше, ___________________________, в том числе его работники не несут

                                                                                    ^{наименование организации}

ответственности за жизнь и здоровье моего ребенка.

____________________                                                                               ___________________

                              ^{дата                                                                                                                                                                                подпись}