I authorize treatment by a licensed medical provider/dentist of the minor in the event of a medical/dental emergency that, in the opinion of the attending provider/dentist, may endanger his/her life, cause disfigurement, physical impairment, or undue discomfort if delayed. The authority granted is only to be exercised after reasonable efforts have been made to reach me, if time so permits. If I cannot be reached, I authorize the school principals, teachers, certified CPR/First Aid staff, or my designated contact person, to call or drive my child to the provider or dentist listed above, or the nearest hospital, if emergency care is needed. An ambulance may be called if necessary. This release form is completed and signed of my own free will and is for the sole purpose of authorizing necessary medical treatment under emergency circumstances in my absence. Special Accommodations: Parents/guardians of students with disabilities who need special accommodations to participate in activities should contact the school prior to activity date.