Authorisation to treat a minor and medical information release. Irlanda 2024

In the event of a Medical Emergency we the parents /guardians of the above named child do hereby consent to any medical or surgical treatment deemed advisable and recommended by a licensed medical practitioner or medical consultant and hereby release Live N Learn and Language Learning International, their agents or representatives including the High School, Host Family, area representative ( hereafter known as the Designated Adults) and medical team from any liability thereunder. I/We further agree to assume financial responsibility for all costs associated with the care and treatment of my dependent child.

I further authorise any hospital, clinic, physician, nurse, psychologist, psychiatrist or healthcare professional to release any and all records and information pertaining to my child’s medical condition to the custody and safekeeping of the Servants or Agents of Language Learning International. Topaz Building, Taney Road, Goatstown, Dublin 14.

Expiration Date: This authorisation lapses 18 months after the date hereunder. Facsimiles: A copy or facsimile of this authorisation is as valid as the original.