Please read the following statements carefully and sign below indicating that you have read and agree to the following:
-I have fully disclosed to Calvary Church/Shining Stars Respite all pertinent facts about my attendee's special needs and accept full responsibility for failure to do so.
-If my child is enrolled in the Shining Stars Respite program,I authorize the staff to provide any required special treatment or procedures to to them while in their care. I will provide instructions and all supplies for these procedures.
-I will supply necessary foods, drinks, snacks, diapers/wipes for attendee.
-In case of emergency or accident, I understand that 911 will be called. I authorize EMS to administer any medical treatment, medication or appliance deemed necessary. I also authorize transportation by EMS to the nearest appropriate medical facility as determined by EMS. I understand I will be responsible for payment of all EMS, hospital and physician charges for emergency services to attendee.