I {name-1-first-name} {name-1-last-name} hereby give my proxy to UPLAY Canada Inc. staff to make decisions regarding emergency medical treatment for my child/ward {name-2-first-name} {name-2-last-name} in the event that neither of the child/ward's parents can be reached at a time when any such decisions need to be made, and I hereby consent to emergency medical treatment, hospitalization or other medical treatment as may be deemed necessary for the welfare of my child, in the event of injury or illness in my absence.