authorized by the parent/guardian 9. to be responsible for the transportation of the child for medical, dental, recreational, and therapeutic appointments, and to have a plan for transportation in a medical emergency 10.9 immediately notify Children's Residential Staff and biological parent/guardian, of any serious illness, injury, hospitalization, accident, runaway, or death of a child. A critical incident form will be completed and provided to Children's Residential Staff. Staff will be nofified immediately of any circumstances of a Residential Parent's inability to provide care 11.10 administer and document medications 12.10 collaborate with birth parent(s) and support staff when making significant decisions about behavior concems, psychotropic medications and any other changes which may possibly infringe upon the child’s basic rights and/or privileges 13.to immediately notify Children’s Residential Staff of an emergency situation requiring termination of the care of a child With my signature, | agree with the above stated terms: Biological Parent(s) and/ or Guardian Date Foster Parent(s) Date Children’s Residential Program Staff Date Children’s Services Supervisor Date