Common use of MEDICAL SERVICES AUTHORIZATION Clause in Contracts

MEDICAL SERVICES AUTHORIZATION. As the parents, or legal guardians of the Participants, we authorize representatives of TPS who are accompanying the Participants on the Retreat Trip, or other qualified physicians and/or nurses, to obtain medical services for Participants where the participant has become ill or injured or is otherwise in apparent need of medical attention during the course of participation in the Retreat Trip. We agree and understand that should a serious or life-threatening medical emergency arise, initial treatment of the participant may be rendered by an adult who may be present, if in the opinion of that individual, delay may endanger the Participant’s life, cause disfigurement, or undue discomfort. We have accurately reported in the medical forms submitted to TPS pursuant to District Policy, any medical conditions including but limited to allergies, or ongoing medical treatment which might influence the treatment of the participant. We agree and understand that TPS does not assume any responsibility for loss of Participants’ personal belongings including but not limited to medications, passports, airline tickets, or other travel documents, or loss or damage to the Participants’ personal belongings including but not limited to luggage, electronic devices, cell phones, iPods, iPads, or other personal technology devices. This Agreement contains the entire agreement between the parties regarding Release of Liability, Assumption of Risk, and Medical Services Authorization, and supersedes any prior Agreement between the parties, whether oral or written, on the subject of liability, indemnification, hold harmless, and waiver or release of claims. Any amendment or change to this Agreement must be made in writing and signed by both parties. This Agreement shall be binding upon the Participants their heirs, representatives, successors, and assigns. OPPORTUNITY FOR THE PARTICIPANTS TO PARTICIPATE IN THE _Retreat TRIP), ASSURANCE _All-School Retreat SAMI Participation Agreement Date: Signature of Parent Date: Signature of Parent I am 18 years of age or older and, by signing this Release of Liability, Assumption of Risk, and Medical Services Authorization Agreement, I accept all of its terms: Date: Signature of Student (If 18 years or older) ACCEPTED: TACOMA PUBLIC SCHOOLS _SAMI SCHOOL By: Its: Date: 8:00 Check-in at Xxxx Parking Lot 9:00 Leave for Black Lake 9:30 Luggage arrives at camp, unload gear 10:00 Arrive at Black Lake, all school activity in the field 10:45 Welcome to Camp!

MEDICAL SERVICES AUTHORIZATION. As the parents, or legal guardians of the Participants, we authorize representatives of TPS who are accompanying the Participants on the Retreat Trip, or other qualified physicians and/or nurses, to obtain medical services for Participants where the participant has become ill or injured or is otherwise in apparent need of medical attention during the course of participation in the Retreat Trip. We agree and understand that should a serious or life-threatening medical emergency arise, initial treatment of the participant may be rendered by an adult who may be present, if in the opinion of that individual, delay may endanger the Participant’s life, cause disfigurement, or undue discomfort. We have accurately reported in the medical forms submitted to TPS pursuant to District Policy, any medical conditions including but limited to allergies, or ongoing medical treatment which might influence the treatment of the participant. We agree and understand that TPS does not assume any responsibility for loss of Participants’ personal belongings including but not limited to medications, passports, airline tickets, or other travel documents, or loss or damage to the Participants’ personal belongings including but not limited to luggage, electronic devices, cell phones, iPods, iPads, or other personal technology devices. This Agreement contains the entire agreement between the parties regarding Release of Liability, Assumption of Risk, and Medical Services Authorization, and supersedes any prior Agreement between the parties, whether oral or written, on the subject of liability, indemnification, hold harmless, and waiver or release of claims. Any amendment or change to this Agreement must be made in writing and signed by both parties. This Agreement shall be binding upon the Participants their heirs, representatives, successors, and assigns. OPPORTUNITY FOR THE PARTICIPANTS TO PARTICIPATE IN THE _Retreat TRIP), ASSURANCE _All-School Retreat SAMI IDEA Participation Agreement Date: Signature of Parent Date: Signature of Parent I am 18 years of age or older and, by signing this Release of Liability, Assumption of Risk, and Medical Services Authorization Agreement, I accept all of its terms: Date: Signature of Student (If 18 years or older) ACCEPTED: TACOMA PUBLIC SCHOOLS _SAMI IDEA SCHOOL By: Its: Date: 8:00 Check-in at Xxxx Parking Lot 9:00 Leave for Black Lake 9:30 Luggage arrives at camp, unload gear 10:00 Arrive at Black Lake, all school activity in the field 10:45 Welcome to Camp!

MEDICAL SERVICES AUTHORIZATION. As the parents, or legal guardians of the Participants, we authorize representatives of TPS who are accompanying the Participants on the Retreat Trip, or other qualified physicians and/or nurses, to obtain medical services for Participants where the participant has become ill or injured or is otherwise in apparent need of medical attention during the course of participation in the Retreat Trip. We agree and understand that should a serious or life-threatening medical emergency arise, initial treatment of the participant may be rendered by an adult who may be present, if in the opinion of that individual, delay may endanger the Participant’s life, cause disfigurement, or undue discomfort. We have accurately reported in the medical forms submitted to TPS pursuant to District Policy, any medical conditions including but limited to allergies, or ongoing medical treatment which might influence the treatment of the participant. We agree and understand that TPS does not assume any responsibility for loss of Participants’ personal belongings including but not limited to medications, passports, airline tickets, or other travel documents, or loss or damage to the Participants’ personal belongings including but not limited to luggage, electronic devices, cell phones, iPods, iPads, or other personal technology devices. This Agreement contains the entire agreement between the parties regarding Release of Liability, Assumption of Risk, and Medical Services Authorization, and supersedes any prior Agreement between the parties, whether oral or written, on the subject of liability, indemnification, hold harmless, and waiver or release of claims. Any amendment or change to this Agreement must be made in writing and signed by both parties. This Agreement shall be binding upon the Participants their heirs, representatives, successors, and assigns. OPPORTUNITY FOR THE PARTICIPANTS TO PARTICIPATE IN THE _Retreat TRIP), ASSURANCE _All-School Retreat SAMI SOTA Participation Agreement Date: Signature of Parent Date: Signature of Parent I am 18 years of age or older and, by signing this Release of Liability, Assumption of Risk, and Medical Services Authorization Agreement, I accept all of its terms: Date: Signature of Student (If 18 years or older) ACCEPTED: TACOMA PUBLIC SCHOOLS _SAMI SOTA SCHOOL By: Its: Date: 8:00 Check-in at Xxxx Parking Lot 9:00 Leave for Black Lake 9:30 Luggage arrives at camp, unload gear 10:00 Arrive at Black Lake, all school activity in the field 10:45 Welcome to Camp!