A parent/legal guardian only must sign this medical release/consent form for each child registered in order to attend VBS.
The undersigned hereby authorize the Toppenish Church of God, 7th Day as our agent to give consent to surgical or medical treatment by an licensed physician or hospital in the State of Washington to the minor child(ren) listed, when such treatment is deemed necessary by such physician, and we cannot be reached within a reasonable time, by reason of absence from the community, or otherwise.
Such consent may include, but is not limited to, administration of necessary anesthetics, medical treatment, test, x-ray examination, transfusions, injections, or drugs, and the performing of whatever operations may be deemed necessary or advisable. Further, consent is granted to said physician to exercise his/her discretion on authorizing the disposal of any severed tissue or members.
It is understood that this authorization is given in advance of any specific diagnosis, treatment, or hospital care being required, but is given to provide the authority to consent thereto, as our said agent and our child’s attending physician, in the exercise of their best judgment, may deem advisable.
This authorization shall remain effective through July 20, 2019 unless sooner revoked in writing by the undersigned at such time that the child’s attendance at this church is terminated and the church is so notified by the child’s parent/guardian.