Authorization to Provide Necessary Treatment or Emergency Care
I hereby give permission to medical personnel selected by the camp director to order x-rays, routine tests, or other treatment; to release any records necessary for insurance purposes; to release a diagnosis and prescription to camp staff; and to provide or arrange any necessary related transportation for my child. If I cannot be contacted, I hereby give permission to the physician selected by the camp director to secure and administer treatment, including hospitalization. This completed form may be photocopied for trips out of camp. Both side of this form are correct and complete as far as I know, and the person herein described has permission to engage in all camp activities except as noted on this form.