I assume complete responsibility for any damage, accident or injury that may occur to my/our son/daughter from the time of drop off to pick up from the Pomona Catholic campus. I assume all risks inherent in participating in this program. I understand that participation in this program does not give preferential consideration in the admissions process to Pomona Catholic or any other high school. Parent signature hereby authorizes Pomona Catholic School, and or their staff member, or designee as agent for the undersigned to consent to any x-ray, examination, anesthetic, medical, or surgical diagnosis or treatment and hospital care which is deemed advisable by, and rendered under the general or special supervision of any physician and/or surgeon licensed under the provisions of the Medical provision Act on the medical staff of any accredited hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital.
It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required, but is given to provide authority and power on the part of our aforesaid agent to give specific consent to and all such diagnosis, treatment or hospital care, which the aforementioned physician, in exercise of his/her best judgement, may deem advisable. This authorization is given pursuant to the provision of Section 6910 of the civil code of California. This authorization shall remain effective on all dates & times selected.