Emergency Medical Consent Forms for Young People

Dear parents/legal guardians of EYPC young people,

To ensure we are equipped to provide appropriate medical assistance if needed, the parents/legal guardians of young people aged 17 or under are required to submit a completed Medical Consent & Authorization Form. This form is provided in your language and in Polish for the local medical providers.

Important Note Regarding Medical Consent: Please note that this form is intended specifically for emergency situations where any delay in medical intervention would be life-threatening or have severe health consequences.

By signing this document, you are providing consent for emergency procedures in the event that we are unable to reach you. Please be aware that if this form is not signed and provided, it could cause a life-threatening or serious delay in medical care, and you acknowledge this risk by not returning the form.

The following is required:

1. Download and print the form in your language: EYPC Emergency Medical Consent Forms
2. For each young person aged 17 and under:
   1. Signed hard copy of the Emergency Medical Consent Form: The form must be signed in ink. Hospitals and clinics in Poland do not accept digital signatures
   2. Printed copy of parents’ ID showing your signature: For example, your passport or driver’s license. Clinicians and hospital personnel will match this signature to the one on the Consent Form to validate its legitimacy.
3. Additionally, for young people aged 16 or 17: 
   1. Same form also signed by the 16 or 17 year old: In accordance with Polish law, participants aged 16 or 17 must co-sign this document. Please ensure this is done before arrival.
   2. Printed copy of the 16 or 17 year old’s ID showing their signature: For example, a printed copy of a passport, National Identity Card, or driver’s license. 
4. Form completeness: Ensure all sections—specifically medical history, known allergies, and emergency contact details—are fully completed.
5. Bring the printed form and copies of identification to the conference: Your young people must bring these with them to Małe Ciche and submit them to the Consent Form Collection desk at Check-in.

Thank you for your cooperation in providing the necessary information to support your child throughout the conference.