Approval to Dispense Prescription Medicine



Note:

It is understood that the medication is administered solely at the request of and as an accommodation to the undersigned parent or guardian. In considerable of the acceptance of the request to perform this service by an NRCCS designation employee, the undersigned parent or guardian hereby agrees to release the NRCCS, the Steamboat Springs School District and their personnel from any legal claim which they now have or may hereafter have arising out of side effects or other medical consequences of the medication.

Note: the medication must be in a container appropriately labeled by the pharmacy or physician, stating the student's name, name of medication, dosage and the time the medication should be given.