Brighton Academy

Rom 13:12 …Let us therefore lay aside the deeds of darkness and put on the armor of light.

Brighton Academy LLC

Consent for Medical Treatment (Minor)

 

 

Student Name(s): _____________________________________________________________________________________________________________________________________________________________________________________________

 

As the parent or legal guardian of the above named minor(s), I hereby give consent for emergency medical care as prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry.  This care may be given under whatever conditions to preserve life, limb or well-being of my dependent.

 

 

 

 

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Signature of Parent or Guardian                                                                   Date