Permission to Participate and Receive Emergency Medical Treatment
I give permission for the above mentioned child to participate in the activities, programs, and trips (“Activities”) sponsored by CHINESE EVANGELICAL FREE CHURCH OF LOS ANGELES (“CEFC”). In case of a medical emergency during such Activities, I authorize CEFC staff, agents, and/or volunteers to request for or to deliver my child to emergency medical services. In a medical emergency, these persons may also perform first aid or life saving techniques (including but not limited to CPR) that can reasonably be performed by persons who are not medical professionals. In a medical emergency, I give consent for my child to receive professional medical treatment reasonably necessary for my child’s health, and I authorize CEFC staff, agents, and/or volunteers to consent on my behalf to emergency medical treatment for my child. Treatment may include, but is not limited to, anesthesia, x ray, or medical procedures as advised by a physician. I accept all financial responsibilities concerning any medical treatment in such circumstances. In the case of a non-emergency illness, non-emergency injury, or disciplinary situation, I also accept responsibility to have my child picked up promptly after being notified of such. This consent is effective for the period of one (1) year from the signing date.
我允准我上述孩子參加由羅省華人播道會(下稱“播道會”)安排的活動、節目和旅行(下稱“活動”)。如果在此類活動中發生緊急醫療情況,我授權給播道會職員、代理人和/或義工將我的孩子送往緊急醫療服務。在緊急醫療情況下,這些人還可以進行急救或救生技術(包括但不限於心肺復甦術),這些技術可以由非醫療專業人員合理地執行。在緊急醫療情況下,我同意我的孩子接受對其健康作合理而必要的專業醫療,並且我授權給播道會的職員、代理人和/或義工代表,為我的孩子進行緊急醫療。治療可能包括但不限於麻醉、X 光檢查或醫生建議的醫療程序。在這種情況下,我承擔有關任何醫療所需的財務責任。而若出現非緊急病況、非緊急受傷,或紀律處分的需要,在接到通知後,我也會承擔責任立即接回我的孩子。本同意書自簽署之日起一 年內有效。