In order to avoid difficulties in obtaining medical services for your child, should he/she be ill or be injured during program/school-sponsored activity, we ask that you give your consent for hospitalization, medical attention or surgery in the case of an emergency.
The sponsor of the activity will consent to such services on your behalf and on the behalf of the child. Family preference of doctor or hospital will be followed if possible. Should preclude this preference, your child will be transported to the nearest medical facility consistent with the existing circumstances.
I, the parent/guardian have read the above medical plan of procedures.
I hereby designate the sponsor of the activity/field trip to act on my behalf in the event of a medical emergency. He/She may authorize treatment. I hereby assume financial responsibility for hospitalization, medical attention or surgery as might be required.