LIMITED POWER OF ATTORNEY FOR EMERGENCY MEDICAL CARE AUTHORIZATION
I, the undersigned, being the parent or legal guardian of said minor child, know that I may not be available to authorize medical, dental, surgical care and hospitalization for said minor child. In the event of injury, program supervisors shall administer basic first aid, and shall summon emergency services via 911. Supervisors are not trained to provide detailed medical care, and shall not, without prior agreement, provide medications. All costs of emergency care are the responsibility of the participant/participant’s legal guardian(s). NO INSURANCE IS PROVIDED BY THE CITY FOR INJURY TO PARTICIPANTS. All claims for reimbursement of medical care costs, including emergency transportation, are hereby waived.
PARTICIPANT RELEASE TERMS I recognize and understand the activity and give my permission and consent to this participation/membership. I recognize that proper care of equipment, facilities, and adequate supervision will be provided, but that inherent in these activities is a degree of assumption of risk. I do hereby absolve, release and agree to hold harmless the City of Cedar Falls, sponsors, leaders, agents, and volunteers from liability claims in case of accidents.
I HAVE READ THIS DOCUMENT CAREFULLY AND UNDERSTAND IT. I AM SIGNING THIS FREELY AND WITHOUT RESERVATION OR CONDITION. (IF YOU HAVE ANY QUESTIONS ABOUT THIS DOCUMENT DO NOT SIGN IT. CONTACT AN ATTORNEY TO ASSIST YOU.)