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EMERGENCY MEDICAL AUTHORIZATION (please print) Students Name: Birth date: RE Grade Students Address: Mothers/Guardians Name: Home Phone: Work Phone: Cell phone: Fathers/Guardians Name: Home Phone:
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Point by point, here's how to fill out if the above parentsguardians cannot:

01
Begin by providing your own contact information. This will ensure that you can be reached if any issues or further information is needed.
02
Indicate the reason why the above parentsguardians cannot fill out the form. Whether it's due to their absence, inability, or any other valid reason, clearly state this in the appropriate section of the form.
03
Provide alternative contact information for a trusted individual who can act as a temporary or substitute parent/guardian. This person should be someone who can make decisions on behalf of the child and be available for any necessary communication or emergencies during the period specified.
04
If applicable, include any additional instructions or documentation that may be required to support your request. This could include legal documents, medical certificates, or any other relevant information that supports the need for an alternative arrangement.
05
Sign and date the form, ensuring that you have read and understood all the provided information. It's essential to confirm that you assume responsibility for the accuracy of the provided details and that you have the authority to act in the best interest of the child.

Who needs if the above parentsguardians cannot?:

The need for an alternative individual to fill out the form arises when the above parentsguardians are unable to do so. This could be due to various reasons, such as illness, absence, incapacity, or any other valid circumstances that prevent them from fulfilling this responsibility. In such cases, it is crucial to ensure that someone else can step in and fulfill the necessary obligations on behalf of the parentsguardians, acting in the best interest of the child involved.
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If above parentsguardians cannot fulfill their responsibilities, another responsible party may be required to step in.
Another responsible party may be required to file if above parentsguardians cannot fulfill their responsibilities.
The necessary forms and documents must be completed by the new responsible party if above parentsguardians cannot fulfill their duties.
The purpose is to ensure that the necessary information is still reported and responsibilities are met if above parentsguardians cannot fulfill their duties.
The information required to be reported may include financial information, personal details, and any other relevant documentation if above parentsguardians cannot fulfill their responsibilities.
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