Medical Permission. I, the undersigned, parent or legal guardian of , a minor, do hereby consent to the nurse or physician selected by the chaperone in charge of my child to provide any necessary medical treatment. In the event that I cannot be reached in an emergency, I hereby give permission for the nurse, physician or emergency medical service to treat, hospitalize, secure proper treatments for and order injection, anesthesia, or surgery for my child as named above. In the event of any emergencies, the undersigned hereby grants authority to be exercised at the discretion of medical personnel to dispense necessary medication.
Medical Permission. We hereby consent for the Grad Knight Party Producers to obtain medical care for the senior in the case of emergency. Parent/guardian and senior agree to full liability should senior require medical treatment. An Emergency Care Plan needs to be completed and submitted to the Grad Knight Party Producers for all life-threatening allergies. Any other medical concerns for senior will be communicated to Grad Knight Committee prior to event.
Medical Permission. I Hereby grant permission for Koala Bear Child Care to take whatever steps may be necessary to obtain emergency medical care for my child if warranted. Any expenses incurred will be the legal parent/guardian’s responsibility. EQUIPMENT: I hereby grant my child to use all play equipment and materials and to participate in all the activities each day.
Medical Permission. We hereby consent for the NC Senior-All-Nighter Committee to obtain medical care for the senior in the case of emergency. Parent/guardian and senior agree to full liability should the senior require medical treatment. An Emergency Care Plan Needs to be completed and submitted to the NC Senior-All-Nighter Committee for all life- threatening allergies. Any other medical concerns for seniors will be communicated to the NC Senior-All-Nighter Committee prior to the event. NC Senior-All-Nighter Committee is not privy to any medical information, allergies, or courses of treatment submitted to the school district and therefore will not have knowledge of these needs unless communicated by parent/guardian prior to event.
Medical Permission. In the event of an emergency, The undersigned authorizes Camp officials to secure from any licensed hospital, physician, and/or medical personnel any treatment deemed necessary for the immediate care and agree that the undersigned will be responsible for payment of any and all medical services rendered. The undersigned have read and understand the above Waiver and Release of All Claims and understand the effect of the relinquishment of the rights herby waived. Signature of Parent/Guardian Relationship Date
Medical Permission. In case of an emergency, I hereby give permission for an adult sponsor to take my child (full name) to a physician or medical facility and give permission for such medical provider to treat my child. I authorize all reasonable and necessary medical treatment, including, but not limited to, emergency surgery. I assume the responsibility of all medical bills. I also give an adult sponsor the authority to dispense any medications Initial TRANSPORTATION PERMISSION: I give permission for my youth to be transported to and from church sponsored activities in a church, rental, or private vehicle. Initial I Herby, agree with the conduct and protocol stated in the Vintage Handbook for minors. I acknowledge that all Vintage City Church employees and volunteers that are in contact with minors have read and follow this handbook. As a parent/guardian I agree to comply with and adhere to the policies and procedures when working with minors at Vintage City Church. Printed Name Parent/Guardian Authorized signature of Parent/Guardian Date THE FOLLOWING IS INFORMATION HOSPITALS REQUIRE: Name of participant Birth date / / Male Female Weight Grade Home address City/State Zip Home Phone Father’s name Work # Cell # Mother’s name Work # Cell #
Medical Permission. Resident agrees that FIT and its authorized agents and employees, including the Residential Life staff and FIT Health Services, may provide or secure emergency medical care to/for Resident in the event of illness or injury. Emergency medical care may include hospitalization, anesthesia, surgery, and/or other treatment. Resident agrees that FIT is not liable for any costs or expenses associated with any emergency medical care provided and further acknowledges that in the event of a health or safety emergency, FIT may release information about Resident to other persons or entities who may need this information to protect the health or safety of Resident or others. Any such disclosures shall be made consistent with the Family Educational Rights and Privacy Act (“FERPA”).
