Medical Authorization and Release - In the event that my child requires medical attention while participating in the ArtReach GW program at THEARC, I hereby authorize and consent to emergency medical treatment. The program administrator or his or her designee has my permission, in an emergency, has my authorization to take the child to the emergency room of the nearest hospital, and the hospital and its medical staff have my authorization to provide treatment which a physician deems necessary for the wellbeing of the child. I hereby authorize and consent to non-‐emergency minor first aid for my child while enrolled as a participant in the ArtReach GW program, as deemed necessary by the program administrator and/or ArtReach GW staff. I acknowledge, however, ArtReach GW Staff cannot administer over-‐the-‐counter or prescription medication to students on a non-‐emergency basis. I hereby authorize any health plan-‐participating or non-‐participating physician, hospital, or other health care provider to give emergency medical care and treatment to my child at no cost to ArtReach GW at THEARC. I understand that ArtReach at THEARC assume no liability for any medical, hospital, other health care provider and/or related expenses incurred by the child while he or she is participating in ArtReach GW. I hereby release, discharge and agree to hold harmless ArtReach GW and The George Washington University, and their Trustees, agents, employees, representatives and volunteers from any and all liability arising out of or in connection my child’s medical or health care needs. (Name and date) *
