In case of an accident or sudden illness, when a parent or guardian is unavailable, I authorize a school representative to obtain medical care for my student, including necessary transportation, in accordance with their best judgment. I further authorize the doctor named below to provide the care and treatment they consider necessary. If the physician designated below is unavailable, I authorize such care and treatment to be performed by any licensed physician or surgeon selected by the school representative. I agree to pay all costs incurred as a result of the foregoing. Please include Doctor's Name and Student's Medical Number. *