Authorization and Consent to Treat a Minor
I, the undersigned, parent /guardian of the NDP Student, a minor, authorize an administrative member of Notre Dame Preparatory High School as agent(s) for the undersigned to consent to any medical or surgical diagnosis or treatment, anesthetic, x-ray exam, along with treatment and/or hospital care which is deemed advisable by, and is to be rendered under the general or special supervision of any physician or surgeon licensed under the provisions of the Medical Practice Act on the medical staff of any accredited hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital.
I understand that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required, but is given to provide authority and power on the part of our aforesaid agent(s) to give specific consent to any and all such diagnosis, treatment or hospital care which the aforementioned physician in the exercise of his/her best judgment may deem advisable.
Rules and Regulations Acknowledgement
I, the undersigned parent /guardian of said student, acknowledge having read the statement on the rules and regulations of Summer School, I understand its contents, and agree to abide by, and support them.