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 Texas Conference of Seventh Day Adventists Medical Consent 2006

Texas Conference of Seventh Day Adventists Medical Consent 2006

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Health Card No. Group No. Allergies - List speci cs. Shots Date of last tetanus shot Drugs Food Plants Animals Bee/Insect stings Other Anidote Nurse Administered Self Care Explanations Medications Is the attendee currently taking medications Yes No Drug Name Dosage Medical and Liability Release I am applying to participate in an activity of the Youth Ministries Department as scheduled by the Texas Conference of Seventh-day Adventists and I will abide by all Texas Laws rules regulations policies...
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