I hearby give authority to any hospital or doctor to render immediate aid as might be required at the time for hi/her health and safety. It is understood by me that hte expence of htis service will be acceptable by me.
If you have answered "yes" to any of the above, please provide a written action plan in case of medical emergency for your student. Blank action plans are available at the front office.
This Emergency Information and Immunization Record Card is accurate and complete and was provided by: