Medical Treatment Consent

Keeping our Learners Safe

Medical Treatment Consent

The undersigned consents to any emergency or medical treatment that may be necessary for the child at any nearby medical facility, as a result of or in connection with activities at The Biome. On behalf of the child and the undersigned, the undersigned further releases, discharges and agrees to indemnify and hold harmless The Biome, its directors, employees, and agents from and against any loss, claim, liability, damage, cost, or expense that may arise out of or related to the participation of the child in activities at The Biome.

Select the number of children for whom you are completing this form.(Required)

1st Child's Name(Required)

First Last

2nd Child's Name

First Last

3rd Child's Name

First Last

4th Child's Name

First Last

5th Child's Name

First Last

6th Child's Name

First Last

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Parent's Name(Required)

First Last

Parent's Signature(Required)

Date(Required)

FORMS & LINKS

Keeping our Learners Safe

Medical Treatment Consent

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4471 OLIVE STREET, SAINT LOUIS, MO 63108 | 1-314-531-0982 | CONTACT

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