EMERGENCY MEDICAL FORM
    In the event that I cannot be reached to make arrangements for emergency medical attention, I authorize First United Methodist Church of Denham Springs Mother's Day Out Program Staff to take my child to an Emergency Room or the following physician or his/her associates, for medical care.

    Medical Concerns or Physical Difficulties:

    ​Known Allergies?

    Is your child allergic to any type of nuts? If so, what kind?

    What kind of reaction can we expect?

    Is your child allergic to insect bites?

    If so, what kind of reaction can we expect?

    I give my consent for any and all treatments deemed necessary by the attending physician.