Medical Release and Authorization
As the participant(s) named below, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional in the event of a medical emergency, which, in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of my life, physical disfigurement, physical impairment, or other undue pain, suffering, or discomfort, if delayed.
Permission is hereby granted to the attending physician to proceed with any necessary medical or minor surgical treatment, x-ray examination, and immunizations for myself. In the event of an emergency arising from serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact my designated emergency contact in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach my emergency contact.
Permission is also granted to GBT and its affiliates, including directors, teachers, and event staff, to provide any necessary emergency treatment prior to my admission to a medical facility.
This release is authorized for the duration of the registered program or event.
This release is executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances for the protection of my life and health.