Signatures/Emergency Care Authorization Sample Clauses

Signatures/Emergency Care Authorization. I, , parent/legal guardian of (Parent’s Name) (Child’s name) Give consent for CYTP representative or Family Child Care provider to authorize transportation of my child/youth/teen for medical or dental in an emergency situation where my child’s condition presents a serious or imminent threat to his/her health, or well-being. I understand that a conscientious effort will be made to notify me prior to such action and the expense if any will be borne by me. By signing this agreement, all parties agree to all of the above terms and policies, including financial responsibility for care provided and that they are eligible for these services. CYTP reserves the right to change policies as needed with advance written notice. Sponsor’s Signature Date Spouse’s Signature Date
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Related to Signatures/Emergency Care Authorization

  • ACH Authorization Merchant authorizes Service Provider to initiate debit/credit entries to the Designated Account, the Reserve Account, or any other account maintained by Merchant at any institution, all in accordance with this Agreement. This authorization will remain in effect beyond termination of this Agreement. In the event Merchant changes the Designated Account, this authorization will apply to the new account.

  • Information Release Authorization Throughout the Term, you authorize DES to obtain information from the DSP that includes, but is not limited to, your account name, account number, billing address, service address, telephone number, standard offer service type, meter readings, and, when charges hereunder are included on your DSP xxxx, your billing and payment information. You authorize DES to release such information to third parties, including affiliates that need to know such information in connection with your Retail Power service. These authorizations will remain in effect as long as this Agreement is in effect.

  • Interconnection Customer Compensation for Actions During Emergency Condition The CAISO shall compensate the Interconnection Customer in accordance with the CAISO Tariff for its provision of real and reactive power and other Emergency Condition services that the Interconnection Customer provides to support the CAISO Controlled Grid during an Emergency Condition in accordance with Article 11.6.

  • Emergency Contact Information Resident must complete and provide to University an emergency contact information form provided by University Housing before Resident will be allowed to move into the Residence Facility.

  • Contractor Certification regarding Business with Certain Countries and Organizations Pursuant to Subchapter F, Chapter 2252, Texas Government Code], Contractor certifies Contractor is not engaged in business with Iran, Sudan, or a foreign terrorist organization. Contractor acknowledges this Agreement may be terminated and payment withheld if this certification is inaccurate.

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