2024 GDS Consent to Emergency Medical Treatment

GEORGETOWN UNIVERSITY

Summer Conference Programs

Offices of Summer and Conference Housing and Campus Activities Facilities


Consent To Emergency Medical Treatment 

In the event that my child requires medical attention, I hereby authorize and consent to emergency medical treatment for my child/ward while participating in a summer conference program at Georgetown University. The program administrator or their designee has my permission, in an emergency if I cannot be contacted, to take my child/ward 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 my child/ward.

I hereby authorize and consent to non-emergency minor first aid for my child/ward while enrolled as a participant in the Georgetown Summer Conference Program, as deemed necessary by the program administrator, counselors and/or Georgetown Emergency Response Medical staff (GERMS).


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Email *
Child's Name *
Parent or Guardian Signature (electronic signature) *
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This form has been completed by the parent/guardian of a 2024 Georgetown Debate Seminar student. *
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