Form 2909 at a glance
What it is: Form 2909 (NOV 15) is the South Carolina Department of Social Services Child Care Licensing Family Child Care Home Consumer Parent Statement. Edition of NOV 07 is obsolete.
Who signs: Print the Parent(s) Name, sign as Parent(s) Signature and enter the Date on each Date line.
A filled-in Form 2909 example: a parent lists one child
How to fill out Form 2909, box by box
Child's Name, DOB, Age, Arrival, Departure and Days In Facility
This form should be completed by parent(s) whose child(ren) are enrolled in a registered family child care home. Additional forms should be completed when new children are enrolled in the facility. This form should be returned to the family child care home operator for submission to the Department of Social Services.
For each child, enter the Child's Name, DOB, Age, Arrival, Departure and Days In Facility (M-TU-WED-TH-FRI).
Who operates the family child care home located at
Fill in the line after "who operates the family child care home located at".
Signature on this form
Your signature on this form verifies that you have been given a copy of the South Carolina Department of Social Services regulations and suggested standards for family child care homes.
You understand that complaints regarding the health and safety of the children, child abuse, or over enrollment are to be reported to the staff of the Department of Social Services.
Parent(s) Address and Telephone Number(s)
Enter the Parent(s) Address and the Telephone Number(s).
Sources
[1] Form 2909 (NOV 15), South Carolina Department of Social Services (the Official source link on this page).