The undersigned _______________________________________, being the parents/ guardians of a student of the Fort McMurray Public School Division, do hereby request and authorize personnel employed by the Fort McMurray Public School Division to provide necessary first aid and prescribed medication and other prescribed treatment to the said student and, for so doing, this will serve as a release and indemnification of and from any action or inaction of any personnel of the Fort McMurray Public School Division associated with the rendering of first aid or administering of prescribed medication and other prescribed treatment to the said student.
Further, the undersigned parents/guardians recognize and acknowledge that the personnel employed by the Fort McMurray Public School Division who may, as a result of this request, be rendering first aid or administering prescribed medication or other prescribed treatment to the said student are not medical practitioners.
DATED at the _________________of ____________________________, in the
Province of Alberta this_________day of____________________,20____
Signature of Parent/guardian _______________________________________
Signature of Parent/guardian________________________________________