We, the undersigned parent or guardian of, ____________________________________ a minor, do hereby consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital service that may be rendered to said minor under the general or special instructions of____________________________________, M.D., or any physician the school or organization may call, whether such diagnosis or treatment is rendered at the office of said physician or at a licensed hospital. It is understood that reasonable effort will be made to contact the doctor listed above before any other physician is called by the school. It is further understood that this consent is given in advance of any specific diagnosis or treatment which might be required and is given to authorize Rogue Valley Adventist Academy or the physician to exercise their best judgment as to the requirements of such diagnosis or treatment.