Medical Treatment Authorization. Permission is hereby granted for any chaperone, any of the Organizers’ staff, or adult present or in charge of first aid, to authorize and to obtain medical attention, hospitalization, or medication in case of sickness or injury to Participant. By signing below, undersigned acknowledges that the Organizers have undersigned’s permission to make all medical/dental/surgical decisions regarding health care emergencies and to provide for medical care for Participant during the Event. The undersigned hereby accepts any and all financial obligations incurred as a result of such immediate medical treatment, and subsequent related costs.
Medical Treatment Authorization. As the parent/guardian of (please print student’s name), a student participating in the Global Youth Leadership Institute, I authorize physicians and/or other medical personnel, at the direction of GYLI or my child’s/xxxx’x chaperone to provide medical care to my child/xxxx while he/she is away from home and participating in the GYLI, including examining, treating and prescribing medications for her/his care. I understand that the faculty and staff and/or the chaperone will, to the greatest extent possible, consult with me concerning the reasons for and effects of all such care. Recognizing that it may be impossible to reach me in situations in which the physicians treating my child/xxxx believe that beginning treatment is medically necessary, I authorize GYLI or the chaperone to permit commencement of treatment when, in the professional judgment of the physicians or medical personnel involved, such treatment is medically necessary, even if I/we have not yet been consulted. In authorizing such emergency treatment, I agree to accept the determination of the treating physician or surgeon that the treatment or examination rendered was medically necessary to protect the life, health or mental well-being of my child/xxxx. I give this authorization on the condition that the treating physician will attempt to contact me, if at all possible, before the treatment or examination is rendered. Parent/Guardian Date
Medical Treatment Authorization. In the event of illness and/or injury, I (parent/legal guardian named below) do hereby consent to whatever medical or dental diagnosis and/or examination, emergency care and/or transportation to hospital or clinic, treatment, x-rays, anesthetic, or surgical care is considered necessary in the best judgment of the attending physician, surgeon, or dentist and performed under the supervision of a member of the medical staff of the hospital or facility furnishing medical or dental services for my son/daughter/xxxx.
Medical Treatment Authorization. In the event of an injury or illness, I give permission for my child, to be treated by a qualified athletics trainer, nurse or licensed EMT and/or emergency room staff at the local hospital.
Medical Treatment Authorization. I consent to allow Oakwood School to administer first aid or to authorize medical care for my child in its sole discretion. This authorization is given pursuant to Section 6910 of the California Family Code and is intended to be effective both within and without the State of California.
Medical Treatment Authorization. In the event of a medical emergency during SDLC, Parent(s) authorize NAIS to contact emergency medical personnel to provide emergency medical care to the Student Participant while participating in SDLC, including emergency medical examinations and treatments and providing prescription medication. Parent(s) authorize NAIS to contact 911 in the event of an emergency and understand that whether such an event is an emergency shall be determined in the sole discretion of NAIS. By signing below, Parent(s) understand that this may include ambulatory care and transportation. Parent(s) recognize that the School and NAIS should attempt to contact Xxxxxx(s) to communicate regarding care but that such communication may not be possible or practicable in certain circumstances and authorize NAIS to commence and oversee such medical care. Parent(s) further authorize the treatment or care that is medically necessary, in the professional opinion of attending physicians and emergency responders, even in the event they cannot be reached. By signing below, Parent(s) give all such authorizations, agree to accept the determinations of NAIS and the attending medical professionals, and accept all associated costs. NAIS makes no representations or undertakings as to the kind, quality, or appropriateness of SDLC for any particular student, nor does it guarantee any particular educational outcome. By signing below, Parents understand that NAIS may, in its sole discretion, change without notice its offerings, activities, schedules, and personnel for SDLC, as well as policies, procedures, and practices, as circumstances may warrant. This discretion includes, but is not limited to, hosting a virtual or hybrid conference, as determined appropriate by NAIS.
Medical Treatment Authorization a. I acknowledge that I have consulted with a medical doctor regarding personal medical needs and there are no physical or mental health-related reasons to preclude participation from the PROGRAM.
b. I acknowledge that on rare occasions an emergency may develop in which I would require the administration of medical care, hospitalization, or surgery. I authorize the UNIVERSITY, PROGRAM faculty and staff and its representatives(s) to secure any necessary treatment deemed appropriate, including administration of anesthetics and/or surgery.
c. I acknowledge that medical care abroad may vary in quality and availability from medical care and services in the United States.
d. I am solely responsible for my health and safety while participating in the PROGRAM and while engaged in independent travel during the PROGRAM dates.
Medical Treatment Authorization. As the parent(s)/guardian(s) of a student participating in the Freshman Retreat I am aware that no medical personnel will be attending the trip. Therefore, I authorize physicians and/or other medical personnel to provide medical care to my child while he/she is away from home and participating in the Freshman Retreat including examining, treating and prescribing medications for their care. I understand that the physicians and/or other medical personnel on location will, to the greatest extent possible, consult with me concerning the reasons for and effects of all such care. Recognizing that it may be impossible to reach me in situations in which the physicians treating my child believe that beginning treatment is medically necessary, I authorize commencement of treatment when, in the professional judgment of the physicians and/or other medical personnel involved, such treatment is medically necessary, even if I/we have not yet been consulted. In authorizing such emergency treatment, I agree to accept the determination of the treating physician or surgeon that the treatment or examination rendered was medically necessary to protect the life, health or mental well-being of my child.
Medical Treatment Authorization. By executing this Agreement, You also intend that this document qualify and act as a caregiver authorization affidavit under Section 6550 et seq. of the California Family Code. As such, while your Student is in the care and custody of Page Academy, You hereby authorize Page Academy and its employees, officers, directors and agents to make all emergency and non-emergency healthcare decisions and execute all related documents, including, but not limited to, insurance and waiver forms, the right to approve or decline medical, surgical, diagnostic tests, hospitalization, health care, personal care services in any situation in which You are unavailable or incapable of making or communicating a decision with regard to your Student's medical care. You also grant permission to Page Academy to administer First Aid, arrange for medical care and treatment in case of a medical emergency, employ and discharge physicians and other healthcare personnel to examine, diagnose, and treat or secure proper treatment for your Student as they shall determine is proper and
Medical Treatment Authorization. In the case of accident or illness, I give MoPOP permission to seek medical care which may be deemed necessary for Camper. In the event the Emergency Contact(s) cannot be Allergies and/or Medical Conditions Food: Other: Treatment(s) and/or additional care notes: Medication Information Name of Medication (as it appears on the label): Dosage: Start Date: End Date: Administration Instructions: (e.g. give 1 tablet at lunchtime with food) Reason for medication/medical need: Possible side effects of medication: Additional Information:
