Contact

Grant of Consent

In the event reasonable attempts to contact the parents or guardians have been unsuccessful, I hereby give my consent for:

1. The administration of any treatment deemed necessary by preferred doctor/dentist or in the event designated doctor/dentist is not available, by another licensed physician or dentist.
2. The transfer of the child to preferred hospital or any hospital reasonably accessible.

Refusal of Consent

I DO NOT give consent for emergency medical treatment of my child. In the event of illness or injury requiring emergency treatment, I wish the Columbia Girls Fastpitch to take no action or to perform the following actions (please state actions in following field).