This form grants authority to the College or its employees to consent to and arrange for medical tre 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the Name of Minor and Date of Birth in the designated fields. Ensure accuracy as this information is crucial for identification.
3. Fill in the Student ID# along with Campus location and Program name. This helps the College track the minor's enrollment details.
4. Provide the Home Address, including Street, City, State, and Zip Code. This ensures that emergency services can reach you if necessary.
5. Enter Parent/Guardian Name, Relation to Minor, and Phone Number. This information is vital for communication during emergencies.
6. In the consent section, clearly state your name as the parent/legal guardian and sign where indicated. Include the date of signing.
7. List Emergency Contacts with their names, phone numbers, and relation to the minor. Provide at least two contacts for reliability.
8. 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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