In granting this permission, I assume full responsibility for any damage to person or property caused by my child or ward. I further expressly agree that in the event of disciplinary action, or if the health of my child or ward makes it necessary at the discretion of the staff, my child or ward may be forthwith returned home at my expense. I understand that the student accident insurance carried by KATY ADVENTIST CHRISTIAN SCHOOL is in force for this field trip, and I assume financial responsibility for any medical or dental expense incurred over and above that covered by the student accident insurance.
We, the undersigned, do hereby consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital service that may be rendered to said minor under the general or special instruction of the school personnel, whether said diagnosis or treatment is rendered at the office of said physician/dentist or at a licensed hospital.
It is understood that this consent is given in advance of any specific diagnosis or treatment being required but is given to encourage the school personnel and said physician/dentist to exercise their best judgment as to the requirement of such diagnosis or treatment.
It is also understood that every possible attempt will be made to contact the parents first; only in case of extreme emergency and failure to be able to contact the parents will this apply. It is further warranted that is this consent form is signed by one or two parents or guardians; it is with the authority of the other.
Sponsors for this field trip are:
Nidia Moller cell 817-903-9202 Ron Moller cell 832-773-1303
Maria Morales cell 713-301-3097
(other staff or volunteer may assist in these outings, but one of the above named shall also be present)