This form is to grant the attending physician to proceed with any medical or minor surgical treatment, x-ray examinations, or immunizations for your student.  

In the event of a serious injury or illness, the need for major surgery, or significant accidental injury, I understand that an attempt will be made by the attending physician to contact me in the most expeditious way possible.  If said physician is not able to communicate with me, the treatment necessary for the best interest of the student may be given.

If an emergency arises during a practice session, an effort will be made to contact the parents or guardians as soon as possible. Permission is also granted to the band directors, volunteers and staff to provide the needed emergency treatment to the student prior to his/her admission to the medical facilities.