Forms: Emergency Medical Consent

I authorize staff in the child care program who are trained in the basics of first aid/CPR to give my child first aid/CPR when appropriate.
I understand that every effort will be made to contact me in the event of an emergency requiring medical attention for my child. However, if I cannot be reached, I hereby authorize the program to transport my child to the nearest medical care facility, and to secure necessary medical treatment for my child.

Emergency Contacts

(In order to be contacted in the event a parent cannot be)




Please enter your email so we can contact you with any questions.
By entering my name above, I confirm that all the information entered is accurate and correct as of this date. This permisson will be considered valid for one year.