Medical Release
The information in this application is correct so far as I know, and the minor child listed has permission to engage in all program activities, except as noted on this application. The undersigned do hereby authorize the directors of Royal Family Kids' Camp, or such substitute as they may designate as agent for the undersigned to consent to an x-ray examination, anesthetic, medical, dental or surgical diagnosis or treatment and hospital care for the minor child which is deemed advisable by and to be rendered under the general or special supervision of any physician and surgeon, licensed under the provision of the Medical Practice Act, or any dentist licenced under the Dental Practice Act, whether such diagnosis or treatment is rendered at the office of said physician or dentist, at a hospital, camp, or elsewhere. I hereby authorize the Royal Family Kids' Camp registered nurse to administer the prescription drugs listed in this application as prescribed for the minor child. This authorization will remain effective while the minor child is in route to and from or involved or participating in any camp activity, unless revoked in writing by the undersigned and delivered to the Director.