Get Ymca Of Metro Atlanta Emergency Information & Waiver And Medical Authorization Form 2020-2025

Completing the YMCA Of Metro Atlanta Emergency Information & Waiver And Medical Authorization Form online is an important step in ensuring the safety and well-being of your child during their participation in YMCA programs. This guide will walk you through each section of the form, providing clear instructions to help you fill it out accurately and efficiently.

Follow the steps to complete the form online

1. Click ‘Get Form’ button to access the YMCA Of Metro Atlanta Emergency Information & Waiver And Medical Authorization Form and open it for completion.
2. Enter the print name of the parent or guardian in the designated field, followed by the date on which you are filling out the form.
3. Complete the child’s information section. You will need to enter the first name, last name, age, and birth date of your child. Indicate the child’s gender by selecting the appropriate checkbox.
4. Answer the series of medical-related questions about your child. For each question regarding previous hospitalizations, disabilities, or medication, select either 'Yes' or 'No' and provide additional details as necessary in the blank fields provided.
5. Fill out the health insurance information by providing the physician’s name, phone number, policy number, medical insurance carrier, and group number.
6. Designate the initial emergency contact by providing the name and phone number of the parent or guardian who should be contacted first in case of an emergency. Include one additional relative and one neighbor’s contact information as backup.
7. Read through the parent/guardian authorization section carefully. Acknowledge the risks and responsibilities outlined in the text, and then sign and date in the space provided.
8. Complete the authorization of treatment section by giving permission for medical personnel to provide emergency treatment. Include the name of the hospital where treatment will be authorized.
9. Acknowledge policies and guidelines by signing once more and dating the form to confirm your understanding of the rules and procedures.
10. Once all fields are completed, you can save changes, download the completed form, print it, or share it as needed.

Ensure the care and safety of your child by filling out the form online today.