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Consent template
Who to call, what a clinician needs to know, and permission to get a child treated and transported when a parent cannot be reached.
Not a sample we wrote for this page. This is the document the product puts in your account, as a draft, the moment you say what you do.
Name your trade during setup — summer camps, schools and field trips — and this is waiting for you, already written, in your words, with the blanks marked and the points a lawyer settles flagged for one. Edit it, or paste in what you already use. It is a starting point and not legal advice: the wording is yours to change and your attorney's to check.
Read off the document itself, so this list cannot drift away from what the document actually asks for.
participant name · date of birth · program name · business name · date · guardian name · guardian phone · second contact · second phone · routine medication · allergies · current medication · conditions · tetanus date · insurance details · vehicle types · private vehicle permission · start date · end date
19 blanks. They are filled once per send, from what you already know or from your own system through the API. They go into the document; they do not change its wording, and what somebody signed is the version they were shown.
These are the notes already written into the document, not our opinion about the law where you operate. The product refuses to send a document with one still in it, which is the point of them.
check what a programme's staff may lawfully administer where you operate, and what must be recorded.
SignSealer does not give legal advice and this document is not legal advice. What it does is put the questions in front of you before somebody signs, rather than after.
The real text, with the blanks shown as blanks and the notes above lifted out so they are read rather than skimmed past.
Emergency Medical and Transportation Authorization
For participant name, born date of birth, at program name, business name. Signed date by guardian name, parent or legal guardian.
1. Who to call first. guardian name on guardian phone. If I cannot be reached: second contact on second phone.
2. Emergency medical care. If the child is injured or becomes ill and I cannot be reached in time, I authorise business name's staff to obtain emergency medical, dental and surgical care for the child, including transport by ambulance, and I authorise the treating clinician to provide care they judge necessary. I am responsible for its cost.
3. Everyday care. Staff may give first aid, and may give the following as written here: routine medication. Nothing else is given without speaking to me.
4. What the clinician needs to know. Allergies: allergies. Current medication: current medication. Conditions: conditions. Last tetanus, if known: tetanus date. Insurance or health cover: insurance details.
5. Transportation. I authorise the child to be transported by business name in the vehicles it uses for the programme — vehicle types — driven by staff or by a contracted carrier, to and from the activities and trips listed in the permission form, and to medical care in an emergency. Seat belts and, where the law requires them, child restraints are used at all times.
6. Private vehicles. Whether staff may carry the child in a private vehicle is set here: private vehicle permission.
7. Telling me afterwards. business name will tell me as soon as it can about any injury, illness or treatment, however minor, and will record it.
This authorization runs from start date to end date and I may withdraw it in writing at any time.
By signing I confirm that I am the child's parent or legal guardian, that the information here is accurate, and that I meant to sign it.
Other documents of the same kind in the library.
A guardian's permission for a programme and its activities, with collection, photographs, swimming and health all answered as fields.
A guardian's consent for a minor aboard, including the life jacket rule and the adult responsible for them on the boat.
A short record made at handover, signed by both sides, saying what condition a thing was in before it left.
A parent or legal guardian's consent for a child to take part, signed by the adult rather than written on the child's form.
Before a colour, a lightener or a smoothing treatment: what is already on the hair, what cannot be promised, and the patch test answer.
A guardian's consent for a minor on the line, naming the responsible adult who will be within arm's reach.
Free for the first 25 agreements a month. No card to start.