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PARENT/GUARDIAN CONSENT TO TREAT A MINOR FORM
While we will require parents to be on campus there may be a day that you cannot attend and let another parent supervise your children. In this case, we would just like to be prepared.
(This form is valid from date signed through 8/31/26)
As the parent/guardian for all the child(ren) registered above, I do consent to any x-ray, anesthetic, medical, surgical, or dental diagnosis or treatment that may be deemed necessary for my minor child. Further, I understand that all efforts will be made to contact me prior to treatment. In the event I cannot be reached in an emergency, I give permission to the activity leader to make the decisions necessary for treatment. Should there be no activity leader available, I give permission to the attending physician to treat my minor child. I further understand that the doctors, dentists, and other providers attending to my child will take all reasonable safety precautions during their care.
Further, as parent or legal guardian I am responsible for the health care decisions for my minor child and agree that my insurance plan is the primary plan to pay for the dental, medical, or hospital care treatment that is given to my child. Any policy of Winton First Baptist Church sponsoring this event will be used as the secondary coverage.
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