GNBC AWANA 2019-20 Medical Release
*Please fill out one form for EACH child participating.

To whom it may concern,

As a parent and/or guardian, I do herewith authorize the treatment by a qualified and licensed medical doctor of the following person in the event of a medical emergency which, in the opinion of the attending physician, may endanger his/her life, cause disfigurement, physical impairment or undue discomfort if delayed.
In case of a minor, this authority is granted only after a reasonable effort has been made to reach the parent and/or guardian.
Name of Participant: *
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