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This form grants authority to the College or its employees to consent to and arrange for medical tre 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering the Name of Minor and Date of Birth in the designated fields. Ensure accuracy as this information is crucial for identification.
- Fill in the Student ID# along with Campus location and Program name. This helps the College track the minor's enrollment details.
- Provide the Home Address, including Street, City, State, and Zip Code. This ensures that emergency services can reach you if necessary.
- Enter Parent/Guardian Name, Relation to Minor, and Phone Number. This information is vital for communication during emergencies.
- In the consent section, clearly state your name as the parent/legal guardian and sign where indicated. Include the date of signing.
- List Emergency Contacts with their names, phone numbers, and relation to the minor. Provide at least two contacts for reliability.
- Detail any Medical Information Related to Minor such as Allergies, Current Medications, and Pertinent Medical History. If more space is needed, attach a separate page.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2019 | 4.8 Satisfied (125 Votes) |
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