Simon Says Simon Says Simon Says
SUN SCREEN CONSENT
 
I authorize “Simon Says” to apply ___________________________________________
Name of Sun screen                               
 
to my child _______________________________________.
Child’s Name                                    
 

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Doctor's Signature
                Date
   
____________________ 
 ____________________
Parent's Signature
                Date
   
____________________ 
 ____________________
Parent's Signature
                Date