top of page

Emergency Permission Agreement

As the guardian of my child, I give permission for him/her to be taken to the hospital in case of an emergency, and consent to emergency treatment until the time of my arrival at the hospital. I understand that every effort will be made to contact me in the event that such an emergency takes place.

As the guardian of my child, I give permission for him/her to be taken to the hospital in case of an emergency, and consent to emergency treatment until the time of my arrival at the hospital. I understand that every effort will be made to contact me in the event that such an emergency takes place.

I Understand that checking the Emergency Permission Agreement check box represents an e-signature and gives consent for my child to participate in the activities outlined on this website. 

bottom of page