Acceptance by Summa Global Education:
1. I/We, the parent(s) named above, do hereby declare that I/We are the parents of the above-named student and/or child (hereinafter the “Student”).
2. I/We consent to Student residing with the Guardian named and identified above (hereinafter the “Guardian”) while attending school in the United States as above.
3. I/We appoint Guardian as guardian of the Student to provide for the care, custody, and control of Student as provided herein.
4. I/We grant and confer onto Guardian the following powers and authority (Where used herein the term “medical” includes, but is not limited to, medical, surgical and dental):
a.To seek appropriate medical treatment or attention on behalf of the Student as may be required by the circumstances, including, but not limited to, medical doctor, psychological counseling and/or hospital visits;
b.To authorize medical treatment or medical procedures on behalf of Student in an emergency situation;
c.To pick Student up from school or other activities;
d.To sign release forms for sports and field trips;
e.To travel with the Student around the State and/or outside of the State;
f.To enforce the agreed-upon terms in the Host Family Agreement;
g.To represent the interests of the Student in any interaction with his/her/their school;
h.To request and receive any and all medical information and documentation, including but not limited to those sent to or received by the Student’s school; and
i.To furnish and provide care and services to Student as may seem necessary, proper, or desirable in the Student’s best interests and welfare; including, but not limited to, food, clothing, shelter and education.
5. I/We expressly direct that for all purposes, a photocopy of this Authorization and Consent shall be deemed to be an original and that any person shall be authorized to act upon such a copy as if it were an original.
6. I/We consent hereto and confer the powers and authority granted herein freely and knowingly in order to provide for the Student and not as a result of pressure, threats or payments by any person or agency.
7. I/We agree that this Authorization and Consent is subject to consent by Summa Global Education. Such consent of Summa Global Education shall be indicated by acceptance below only. Without Summa Global Education’s signature of acceptance below, this Agreement shall be null and void. This Authorization and Consent may be terminated by Summa Global Education for any or no reason, at the sole discretion of Summa Global Education immediately upon notice.
8. By his/her signature below, the Student understands, acknowledges, and agrees to this Authorization and Consent and to the extent required, authorizes, agrees and consents to the terms of this Authorization and Consent.
Acceptance by Summa Global Education: