Minor Medical Release Form for Oasis for Kids, Inc.<\/p>\n
If my son\/daughter requires medical attention on a trip sponsored by the Oasis organization,
\nI authorize David Duffin or his representative to determine if he\/she can be released from your agency’s jurisdiction. Mr. Duffin has our permission to transport our child to a destination that is closer to us for a medical check up, such as an x-ray.<\/p>\n
Student: (print) ……………………………………………………………….<\/p>\n
Date of Birth: …………………………………………………………………<\/p>\n
Address: ………………………………………………………………………<\/p>\n
………………………………………………………………………………<\/p>\n
EMAIL: ………………………………………………………………………..<\/p>\n
Phone contacts (+ backup relative):<\/p>\n
………………………………………………………………………………<\/p>\n
………………………………………………………………………………<\/p>\n
Parent or Guardian : (print) …………………………………………………….<\/p>\n
Parent \/ Guardian Signature: …………………………………………………….<\/p>\n
Date: …………………………………………………………………………<\/p>\n
Medical Insurance Info and ID # ………………………………………………….
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(PLEASE PRINT THIS FORM AT 100%, Page 1 TO 1; FILL IT OUT, XEROX YOUR MEDICAL CARD IN THE SPACE ABOVE, MAKE 3 COPIES, AND MAIL ONE TO THE ADDRESS BELOW)<\/p>\n
Oasis for Kids, Inc. – A Non-Profit Corp. – 344 Westline Drive – Alameda, CA 94501<\/p>\n","protected":false},"excerpt":{"rendered":"
Minor Medical Release Form for Oasis for Kids, Inc. If my son\/daughter requires medical attention on a trip sponsored by the Oasis organization, I authorize David Duffin or his representative to determine if he\/she can be released from your agency’s …<\/span> Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-258","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"http:\/\/oasisforkids.org\/news\/wp-json\/wp\/v2\/pages\/258","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/oasisforkids.org\/news\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/oasisforkids.org\/news\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/oasisforkids.org\/news\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/oasisforkids.org\/news\/wp-json\/wp\/v2\/comments?post=258"}],"version-history":[{"count":17,"href":"http:\/\/oasisforkids.org\/news\/wp-json\/wp\/v2\/pages\/258\/revisions"}],"predecessor-version":[{"id":583,"href":"http:\/\/oasisforkids.org\/news\/wp-json\/wp\/v2\/pages\/258\/revisions\/583"}],"wp:attachment":[{"href":"http:\/\/oasisforkids.org\/news\/wp-json\/wp\/v2\/media?parent=258"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}