Emergency Medical Authorization
So we can act quickly if a student is hurt or becomes ill during a class or event. A parent or legal guardian completes and accepts this for each enrolled student.
1. Accuracy of information
I confirm that the emergency contacts, allergies, medical conditions, and medications I have provided for the student are accurate to the best of my knowledge, and I will update them if they change. I understand this information may be shared with instructors and staff, and with emergency responders, only as needed to keep the student safe.
2. Consent to first aid
I authorize the Academy’s instructors and staff to administer basic first aid to the student if reasonably necessary during classes, rehearsals, performances, or events.
3. Consent to emergency medical care
In the event of an injury or medical emergency, I authorize the Academy to take the steps a reasonable person would take, which may include: calling 911 or emergency services; arranging for the student to be examined, treated, and transported by paramedics or ambulance; and arranging emergency care by a physician, hospital, or clinic — when I or the student’s emergency contacts cannot be reached in time.
4. Responsibility for costs
I understand that I am financially responsible for any costs of emergency medical care, transport, or treatment provided to the student, and that the Academy is not responsible for those costs.
5. Efforts to reach you
The Academy will make reasonable efforts to contact me and the listed emergency contacts as soon as possible in any emergency. This authorization applies when those efforts cannot be completed quickly enough to protect the student’s health.
6. Authority to consent
I confirm that I am the parent or legal guardian of the student and have authority to provide this authorization on the student’s behalf. This authorization is governed by the laws of the State of Michigan.