Overnight Guest Student Consent

If, in the opinion of a properly licensed and practicing physician, Student needs medical or surgical services which require Parent’s pre-authorization or consent, Parent hereby authorizes, appoints, and empowers the School to act as Parent and furnish such consent on Parent’s behalf. Parent confirms that it is Parent’s desire that the Student be furnished with such medical or surgical services as soon as reasonably possible after the need arises. Parent hereby releases and holds the School harmless from any liability which might arise from the giving of such consent. Parent agrees to reimburse the School for any medical expenditures made on Student’s behalf.

The Parent hereby authorizes the School to supply medical care as needed for Student (including administration of allergy medications, Epi-Pens, etc. according to the Student’s prescription from a licensed practitioner) or other minor medical care or emergency as determined to be appropriate by the School Staff.

The health history indicated on our visit day registration form is accurate so far as I know and the above-stated person has my permission to visit and participate in all activities at Iowa Conservatory. I understand all precautions will be taken for student care and supervision. I entrust care of my child to student life staff during their visit. Beyond this I will not hold Iowa Conservatory Faculty and Staff or Iowa Conservatory responsible or liable.

I understand that it is my duty to ensure proper drop off and pick up my student to and from ICON. I understand and give ICON permission to transport my student by car, or other vehicle, in accordance with field trips or class needs. At times, I understand that my student may ride with other students or friends in order to go off campus to eat, attend an event, or the like. I release ICON from all liability if my student seeks transportation from another person not affiliated with ICON.

We anticipate there may be times when your student needs to take standard over the counter medication for pain relief, allergies, etc. We do not provide an onsite nurse. By checking this box, you understand this and give your child permission to self administer over the counter medications that have been approved.