CENTAURUS HIGH SCHOOL BANDS, 2019-2020

I (we) the undersigned parent(s) or legal guardian(s) of the undersigned student do hereby authorize and consent to any x-ray examination, anesthetic, medical or surgical diagnosis rendered under the general or specific supervision of any member of the medical staff and emergency staff licensed under the provisions of the Medical Practice Act or a dentist licensed under the provisions of the Dental Practice Act and on the staff of any acute general hospital holding a current license to operate a hospital from the Colorado Department of Public Health.  It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospitalization being required but is given to provide authority and power to render care which the aforementioned physician, it the exercise of his or her best judgment, may deem advisable.   It is understood that the effort shall be made to contact the undersigned prior to rendering treatment to the patient, but that any of the above treatment will not be withheld if the undersigned cannot be reached.