Physical and medical release forms

Eaton Early Learning Center Physical and Medical Releases
Physician_______________________________________	Phone ____________________________
Dentist_________________________________________	Phone ____________________________
Hospital________________________________	Phone ____________________________
I hereby give my permission for the Eaton Early Learning Center to call either of the doctors listed above for any type of emergency that may arise. It is understood that a conscientious effort will be made to locate the parent/guardian before any action is taken. If I cannot be located, I will accept whatever medical costs that may occur.
_______________________________ __________ Signature of Parent/Guardian Date

I hereby give permission to the Eaton Early Learning Center’s staff to take my child on trips away from the school, whether by foot or vehicle. The teachers will give notification of these trips. I also give permission for my child’s photographs to be used in publications in connection with the school or its activities.
_______________________________ __________ Signature of Parent/Guardian Date

The Eaton Early Learning Center’s staff has my permission to take my child on any field trips away from the school grounds for which advance notice has been given ( ) yes ( ) no
_______________________________ __________ Signature of Parent/Guardian Date

In case of serious illness or injury when neither parent can be reached will you allow your child to be transported to the doctor or hospital by an employee of the Eaton Early Learning Center? ( ) yes ( ) no
_______________________________ __________ Signature of Parent/Guardian Date

I herby give permission to the Eaton Early Learning Center to secure emergency medical and/or surgical treatment for the above named minor child while in the care of the above named school. All expenses of such care will be accepted by the parents.
_______________________________ __________ Signature of Parent/Guardian Date