Emergency Treatment Authorization

Applicable to: Spring Break Camp Summer Camp Aug 10_14 Summer Camp Aug 17_21 NS - no extra routine Summer Training Provincial Stream 2024 Spring Break Camp 2024 National Stream Development Program AquaGO Level 1-2 Th or Fr Provincial Stream Summer Training 2026 PS - Team A Development/Recreational Summer Camp JULY Limited Competitive Summer Camp Jul 6_10 Development/Recreational Summer Camp AUGUST Summer Camp Jul 13_17 Summer Training National Stream 2024 National Stream Summer Training 2026 NS - WITH 2nd routine AquaGO Level 3-4 Tu or Fri PS - Team B Summer Camp Jul 20_24 NS Custom AquaGO Level 3-4 We Session 1 - Extra Figures Training AquaGO Level 5-6 Tu Session 2 - Extra Figures Training National Stream Custom K Summer Camp Jul 27_31 Artistic Swim Kids Tue session 2 AquaGO Fri 530-630 S2 Artistic Swimming for Teens Artistic Swim Kids 2 -Tuesday Provincial Stream 16-20 Custom AquaGo Session 2 Artistic Swim Kids Thursdays session 2 National Stream custom SR

AS THE SWIMMER OR PARENT OR GUARDIAN, UNDER CIRCUMSTANCES BELOW, I HEREBY AUTHORIZE THE ADULTS IN CHARGE OF THE TEAM/CLASS, TO SECURE SUCH MEDICAL ADVICE AND SERVICES AS MAY BE DEEMED NECESSARY FOR THE HEALTH AND SAFETY OF MYSELF OR MY DAUGHTER/SON (OR WARD)

AND I AGREE TO ACCEPT FINANCIAL RESPONSIBILITY IN EXCESS OF THE BENEFITS ALLOWED BY PROVINCIAL HEALTH INSURANCE PLAN:

1. Where health and well being of the person is involved;

2. Where medical advice has been such that further services are required, services which require the consent of the parent or guardian;

Where all attempts to contact the parent or guardian have failed or where due to the nature of the emergency, there is insufficient time to contact such parent or guardian.

IT SHALL BE AT THE DISCRETION OF THE ADULTS IN CHARGE OF THE TEAM/CLASS AS TO WHAT STEPS MUST BE TAKEN FOR THE WELFARE AND SAFETY OF MYSELF OR MY DAUGHTER/SON.