2) I hereby authorize the Ocasio Camp Director or Case Western Reserve University Security Staff to act on my behalf to provide first aid for my child, if needed according to their best judgment. In the event that I cannot be reached in an emergency, I hereby give permission to the physician, medical personnel and hospital or medical center selected by the Camp director or Case Western Reserve University Security Staff to secure and administer medications and treatment (including hospitalization), to arrange related transportation, order necessary x-rays and tests, provide anesthesia, or surgery for my child.
3) I hereby authorize the release of any records that the physician, hospital or medical facility at their discretion may deem necessary for treatment of my child, including information contained in this form.
4) I hereby authorize release of related medical records for insurance purposes and payment of medical benefits to the designated physician, provider or hospital for services described herein. I will assume responsibility for fees incurred for such services that are not covered by insurance.