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GIFT DESIGNATIONS
WAYS TO GIVE
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ANNUAL GIVING & MAJOR GIVING
SUPPORT TYM
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Fall Registration
Support
GIFT DESIGNATIONS
WAYS TO GIVE
DONOR BENEFITS
ANNUAL GIVING & MAJOR GIVING
SUPPORT TYM
About Us
Code of Conduct Policy
Student Attendance Policy
Appropriate and Inappropriate Verbal Interactions Policy
Non-Discrimination Policy
Zero Tolerance Policy
Contact
News
Medical Treatment Authorization Form
PARENTS AND GUARDIANS: Please complete this form for each child you are registering.
This form grants temporary authority to the Tucson Youth Music Center and its representatives to arrange for and authorize emergency medical care for a minor in the event that minor is not accompanied by parents or legal guardians or other person(s) designated by the parents and it is not feasible or practical to contact any of them in a timely fashion.
Minor Full Legal Name
*
First
Last
Information For Medical Treatment
Physician’s Name and Location of Practice:
*
Physician’s Phone # (if known)
Medical Insurer/Health Plan
Policy #
Allergies to Medications
Allergies (Other)
Please note all conditions for which the child is currently receiving treatment
Please note any other significant medical information
AUTHORIZATION AND CONSENT OF PARENT(S) OR LEGAL GUARDIAN(S)
Today's Date
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Signature
*
Printed Name
*
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Section End
Email
This field is for validation purposes and should be left unchanged.