Medical Release
Aug 15, 2025 02:17 PM
Medical Release: As the parent/legal guardian of the student/participant named, I request and authorize that in my absence the student/participant named be admitted to any hospital or medical facility for diagnosis and treatment. I request and authorize physicians, dentists, and staff, duly licensed as Doctors of Medicine or Doctors of Dentistry or other such licensed technicians or nurses, to perform any diagnostic procedures, treatment procedures, operative procedures and x-ray treatment of the student/participant. I have not been given any guarantee as to the result of examination or treatment. I hereby authorize Allstar Dance Academy, it’s owners, members, Board of Directors, and all employees and agents of these parties to act for the student/participant in any emergency circumstances requiring medical attention.