Child Information
Parent/Guardian information
Other people allowed to pick-up
Medical Information

I hereby give permission for my child to receive emergency treatment by a qualified staff member at Blossoming Buds Preschool. I also give permission for my child to be taken to the hospital by an aid car, ambulance, or staff car, if necessary.
In the event of an emergency and I cannot be contacted, I further consent to any medical, surgical, and/or hospital care, when deemed immediately necessary or advisable by a licensed physician/hospital in order to safeguard my child’s health.
I understand that I am 100% financially responsible for any emergency treatment that my child receives, including paramedics/ambulance services.
By signing below you agree to the above medical waiver.

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