I, the undersigned, hereby authorize SKI APACHE and any medical or dental persons, to allow ______________________, group leader of the ____________________________ group, to act in my stead and IN LOCO PARENTIS for my child(ren) to make any and all arrangements that are appropriate and in the best interests of my child(ren), for my children’s personal care, skiing rental arrangements, ski school arrangements, lift ticket arrangements, or medical, surgical, or dental care, and:
To give CONSENT in my name and in the name of my child(ren) to any and all types of MEDICAL TREATMENT or procedures, DENTAL TREATMENT or procedures or SURGICAL procedures for my child(ren); To give CONSENT in my name and in the name of my child(ren) to the disclosure of any confidential or privileged communication or information related to the care of my child(ren);
To give CONSENT in my name and in the name of my child(ren) to the disclosure of any confidential or privileged communication or information related to the Ski School, Rental Equipment, and Lift Ticket arrangements for my child(ren); and
To give CONSENT in my name and in the name of my child(ren) to the signing of any and all RELEASE OF LIABILITY AND INDEMNITY AGREEMENTS, being aware that THESE AGREEMENTS DO RELEASE LEGAL RIGHTS on my behalf and on behalf of my child(ren) and to legally bind me, related to the Ski School, Rental Equipment, and Lift Ticket arrangements for my child(ren).
A photocopy of this instrument shall be deemed an original for all purposes.
This document shall be valid for the period of time from