Parent Consent & Approval Form
Pick Up Approval By selecting YES, I am authorizing the people listed above to pick up or receive my child.
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Yes
No
Health Record Transfer By selecting YES, I give authorization for the transfer of my child's health record to the local hospital.
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Yes
No
First Aid Approval. In the event of an emergency, I authorize the staff to provide any first aid care deemed necessary for my child.
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Yes
No
Photography Consent By selecting YES, I am authorizing my child's photograph to be taken to be used on BMK's social media, website, and/or for publicity.
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Yes
No
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I've checked my choices above, and my signature
below gives or denies permission as marked.
Signature
*
Date
*
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Month
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Day
Year
Date
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