Yes I have fully answered this Medical Release Form to the best of my knowledge. I also understand that in the event medical intervention is necessary, every attempt will be made to contact immediately the persons listed on this form. If I cannot be reached in an emergency during Religious Education, I give my permission to the physician selected by the activity leader to hospitalize in order to secure medical treatment and/or an injection, anesthesia, or surgery for my child(ren) as deemed necessary.
I have read and fully understand the requirements outlined by St. Joseph the Worker Catholic Church. By signing this form, I accept the requirements stated in this Medical Release Form.