DESERT ECOLOGY CLASS - 2003
I understand that there is always some small amount of risk when going on an extended field trip, and that all normal/reasonable precautions will be taken for my safety. In the event that I require medical care, I will not hold responsible Dr. Tomasi, the Department of Biology, Missouri StateU, the state of Missouri, or any governing bodies thereof.
Should I require medical care while on this trip and am unable to make my own medical decisions, Dr. Tomasi is authorized to make these on my behalf. Any special medical concerns that I have (allergies, diseases, attacks of various natures, drug reactions, etc) that I have are listed here:
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Signature
Date
Medical Insurance provider: ___________________________________
People I would like notified in case of medical emergency (PRINT up to three):
Names
Relations
Phone numbers
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