MEDICAL PERMISSION STATEMENT
I hereby give South Breeze Day Camp permission to take my child to any hospital
facility or doctor deemed necessary. I hereby give permission to such hospital or
doctor to authorize x-rays and emergency treatment if deemed necessary. I understand
that all medical bills for service rendered by anyone other than the camp’s
medical staff are my responsibility.
I have read the Terms Of Agreement and the Medical Permission Statement above and
understand and accept it’s conditions. In the event this Agreement is executed
by one parent, I acknowledge that I am also acting as the agent of the other parent
with authority to so enroll my child at South Breeze Day Camp and to execute this
Agreement on his or her behalf. I recognize that South Breeze Day Camp relies upon
the representation herein made in accepting this enrollment.
I have read the Enrollment Agreement, and understand its terms and accept it’s
conditions (type your full name, if you agree).