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IMPORTANT--PARENTS / GUARDIANS PLEASE READ!!!
To insure the safety of your children when involved in the AYC Junior Sailing Program activities, we are asking that parents / guardians fill out this form for each participating child. This form will be required to be on file for any junior participating in any AYC Junior Sailing Program.
AUTHORIZATION TO CONSENT TO TREATMENT OF MINOR
The undersigned parent or guardian of the above named child, a minor, do hereby consent to any emergency X-ray, anesthetic, medical, or surgical diagnosis or treatment and hospital care that is deemed advisable by, and is to be rendered under the general or specific supervision of, any duly licensed physician or surgeon.
It is understood that this authorization is given in advance of any specific diagnosis, treatment, or hospital care being required and is given to provide authority and power on the part of the Atlanta Yacht Club, and each of its officers and members, to give specific consent to any and all such diagnosis, treatment or hospital care that any duly licensed physician or surgeon in the exercise of his or her best judgment may deem advisable.
This authorization shall remain effective until revoked in writing.
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