Authorization and Consent for Medical Treatment Sample Clauses
Authorization and Consent for Medical Treatment. I/we the undersigned parent, parents or legal guardian of the above named minor, do hereby authorize in the event of an injury, accident, or illness, ARARAT, its coaches, team representatives, directors, officers, agents, and assignees to seek and obtain care and medical treatment as shall be necessary under the circumstances. I/we hereby authorize and direct the above named to consent to any x-ray examination, anesthetic, medical or surgical diagnosis, or treatment and hospital care which is deemed advisable and rendered under the general or special supervision of any member of the medical staff and emergency room staff licensed under the provisions of the Medical Practice Act, of a dentist licensed under the provisions of the Dental Practice Act, and on the staff of any general hospital holding a current license to operate a hospital from the State Department of Public Health or its equivalent. This authorization is effective whether such diagnosis or treatment is rendered at the office of said physician or dentist, at a hospital, or elsewhere. It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required but is given to provide authority and power on the part of my aforementioned agents to give specific consent to any and all such diagnosis which in the exercise of his or her best judgment may deem advisable. It is understood that effort shall be made to contact the undersigned before rendering treatment to the patient, but that any of the above treatment will not be withheld if the undersigned cannot be reached. I also agree that this authorization to treat shall be valid in any state where such treatment is rendered. I also agree that if English is not my first language that I have sought out someone to translate this form to me and agree that by my signature that I have read and understood the document. A photocopy of this Authorization will have the effect as the original.
Authorization and Consent for Medical Treatment. In the event that my child needs emergency medical treatment during school hours while attending ▇▇▇▇▇▇▇ Academy, I authorize the school, through the school’s administrative staff and faculty, to administer first aid or other medical treatment as deemed necessary under the circumstances. I consent for my child to receive such treatment. I understand the school will attempt to notify me (or other parent/guardian named on this form) in the event of an emergency requiring immediate medical care for my child. If the school is unable to notify me, in case of a serious injury/illness, the school has my permission to arrange transportation to and treatment by a duly-qualified physician at the nearest emergency hospital or clinic. Signature of Parent/Guardian: To parents and guardians, At ▇▇▇▇▇▇▇ Academy, we use Google Workspace for Education, and we are seeking your permission to provide and manage a Google Workspace for Education account for your child. Google Workspace for Education is a set of education productivity tools from Google including Gmail, Calendar, Docs, Classroom, and more used by tens of millions of students and teachers around the world. At ▇▇▇▇▇▇▇ Academy., students will use their Google Workspace for Education accounts to complete assignments, communicate with their teachers, and learn 21st century digital citizenship skills. The notice below provides answers to common questions about what Google can and can’t do with your child’s personal information, including: ● What personal information does Google collect? ● How does Google use this information? ● Will Google disclose my child’s personal information? ● Does Google use student personal information for users in K-12 schools to target advertising? ● Can my child share information with others using the Google Workspace for Education account? Please read it carefully, let us know of any questions, and then sign below to indicate that you’ve read the notice and give your consent. If you don’t provide your consent, we will not create a Google Workspace for Education account for your child. Your child will not have the ability to complete work on Google Classroom as the classes are doing this year. I give permission for ▇▇▇▇▇▇▇ Academy to create/maintain a Google Workspace for Education account for my child and for Google to collect, use, and disclose information about my child only for the purposes described in the notice below. Thank you,
Authorization and Consent for Medical Treatment. This Authorization And Consent For Medical Treatment will be effective commencing on the date of execution shown below.
Authorization and Consent for Medical Treatment. In the event the Applicant is less than 18 years of age at the time of the anticipated trip, or is otherwise legally incapacitated or disabled (consult counsel if you are unsure of this), it is absolutely necessary for the parent/ guardian to sign this portion of the agreement. If the Applicant is 18 years of age or older and is legally capable, he/ she must sign the consent for medical treatment for himself/herself. I hereby give to (name of individual in charge of group) permission to authorize whatever medical treatment may be necessary in the case of (name of participant) , a minor of whom I am the parent or legal guardian, while on a Yorktown Christian Academy and STCH Ministries mission trip to the Dominican Republic. If such treatment is recommended by a competent physician or surgeon and is performed by qualified medical personnel, I will not hold (name of individual in charge of group) or anyone connected with Yorktown Christian Academy and STCH Ministries responsible in case of adverse results or problems that arise from such treatment. It is understood that this release is valid only in case of an emergency and that a reasonable effort will be made to inform me of the problem and seek my personal decision before taking any action. However, if I cannot be reached, the above named person is given my permission to do whatever is necessary. I hereby give to (name of individual in charge of group) permission to authorize whatever medical treatment may be necessary for me, (name of applicant) , while on a Yorktown Christian Academy and STCH Ministries mission trip to the Dominican Republic. If such treatment is recommended by a competent physician or surgeon and is performed by qualified medical personnel, I will not hold (name of individual in charge of group) or anyone connected with Yorktown Christian Academy and STCH Ministries responsible in case of adverse results or problems that arise from such treatment. It is understood that this release is valid only in case of an emergency and that I cannot consent to my treatment myself.
Authorization and Consent for Medical Treatment. In the event that my child needs emergency medical treatment during school hours while attending ▇▇▇▇▇▇▇ Academy, I authorize the school, through the school’s administrative staff and faculty, to administer first aid or other medical treatment as deemed necessary under the circumstances. I consent for my