Medical Form


    A. In case of emergency, when neither parent can be reached, please provide names of two people who will take responsibility for your child:

  • B. If parents cannot be reached, and emergency medical attention is needed, permission is given to the Friendship Circle staff to call my child's doctor.

  • C. In case of medical emergency requiring immediate care, I authorize the paramedics to take my child to the nearest hospital, if necessary.

  • D. Allergies & Medications

  • E. I authorize the Friendship Circle to administer prescription or patent medicine to my child as specified in written instructions.

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