Consent for Emergency Treatment. I authorize the University of Wisconsin-Xxxxxxx Point and its designated representatives to consent, on my behalf, to any emergency medical/hospital care or treatment to be rendered upon the advice of any licensed physician. I agree to be responsible for all necessary charges incurred by any hospitalization or treatment rendered pursuant to this authorization.
Consent for Emergency Treatment. I authorize the University of Wisconsin – Green Bay and its designated representatives to consent, on my behalf, to any emergency medical/hospital care or treatment to be rendered upon the advice of any licensed physician. I AGREE TO BE RESPONSIBLE FOR ALL NECESSARY CHARGES INCURRED BY ANY HOSPITALIZATION OR TREATMENT RENDERED PURSUANT TO THIS AUTHORIZATION.
Consent for Emergency Treatment. I authorize the University of Wisconsin-Whitewater and its designated representatives to consent, on my behalf, to any emergency medical/hospital care or treatment to be rendered upon the advice of any licensed physician. I agree to be responsible for all necessary charges incurred by any hospitalization or treatment rendered pursuant to this authorization.
Consent for Emergency Treatment. The undersigned, as a participant in the subject activity, hereby consent to medical treatment in a medical emergency where the undersigned is unable to consent to such treatment.
Consent for Emergency Treatment. I authorize the Releasees, and their designated representatives to consent, on my behalf, to any emergency medical/hospital care or treatment to be rendered upon the advice of any licensed physician. I agree to be responsible for all necessary charges incurred by any hospitalization or treatment rendered pursuant to this authorization.
Consent for Emergency Treatment. I authorize the University of Wisconsin – Extension - Ozaukee County and its designated representatives to consent, on my behalf, to any emergency medical/hospital care or treatment to be rendered upon the advice of any licensed physician. I AGREE TO BE RESPONSIBLE FOR ALL NECESSARY CHARGES INCURRED BY ANY HOSPITALIZATION OR TREATMENT RENDERED PURSUANT TO THIS AUTHORIZATION.
Consent for Emergency Treatment. In the event of a serious injury, the registrant authorizes the University of Wisconsin-Whitewater and its designated representatives to consent, on their behalf, to any emergency medical/hospital care or treatment to be rendered upon the advice of any licensed physician. Registrants agree to be responsible for all necessary charges incurred by any hospitalization or treatment rendered pursuant to this authorization.
Consent for Emergency Treatment. I authorize UW-OSHKOSH and its designated representatives to consent, on my behalf, to any emergency medical/hospital care or treatment to be rendered upon the advice of any licensed physician. I agree to be responsible for all necessary charges incurred by any hospitalization or treatment rendered pursuant to this authorization.
Consent for Emergency Treatment. I authorize UWM and its designated representatives to consent, on my behalf, to any emergency medical/hospital care or treatment to be rendered upon the advice of any licensed physician. I agree to be responsible for all necessary charges incurred by any hospitalization or treatment rendered pursuant to this authorization.
Consent for Emergency Treatment. In the event I am injured or become ill or incapacitated during the Activity, I consent to Oregon Wild authorizing transportation and evacuation and to obtain appropriate medical care and treatment for me, all at my own expense. Because the activity may occur in a backcountry setting, I understand that emergency medical care may not be readily available.
