Medical Release and Authorization
As Parent and/or Guardian of the named child, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional of the minor child in the event of a medical emergency that, in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering, or discomfort if delayed. I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible.
Permission is also granted to John XXIII Montessori Center and its affiliates, including staff and volunteers, to provide the needed emergency treatment prior to the child’s admission to the medical facility.
Permission is also granted to John XXIII Montessori Center and its affiliates, including staff and volunteers, to provide first aid if the need arises.
Release authorized on the dates and/or duration of the registered camp.