YOUNG CHILDREN’S PROGRAM College of Education James Madison University PERMISSION TO SHARE INFORMATION Name of child _________________________________________________ Name of Adult family member ________________________________________ I give permission for ___________________________________ of the James Madison (name of teacher) University Young Children’s Program to share information about the above-named child with _________________________________________________________________. (name of agency or individual) ___________________________ Date ______________________________________________ Signature of adult family member (An original copy of this document must be maintained in the child’s records at the Young Children’s Program.)