Medical Consent to Treat Minor Child (Each box should remain checked) I, the undersigned, am the parent or legal guardian of the child listed below who is attending the ACT & SAT/PSAT course by College Prep Professionals, LLC at Capital University. I hereby grant permission to the instructors, owners, and/or employees (including Lynn Dailey) of College Prep Professionals, LLC to act on my behalf in the event of a medial emergency while my child is at Capital University.

In the event I cannot be reached, I authorize the aforementioned representatives of College Prep Professionals, LLC to consent to any medical, surgical, or dental examination, anesthetic, or treatment for my child listed below deemed necessary by a licensed physician or dentist. I authorize the use of emergency transportation if necessary, and I agree that I am solely responsible for all costs associated with such transport and medical care.

I agree to release, indemnify, and hold harmless College Prep Professionals, LLC; Capital University; and their respective instructors, owners, and/or employees from any and all claims, demands, and/or causes of action including negligence arising out of or in connection with my child's participation in this course at Capital University.