I hereby give permission to medical personnel to order X-rays, routine tests, and treatment for my child/children. In the event of an emergency and neither the secondary contact nor myself can be reached, i hereby give permission to the physician to hospitalize, secure proper treatment, order injections and/or anesthesia and/or surgery for my child/children as named above. In addition, I have, and hereby release BSFBC its employees & volunteers from any claims.

Selecting "Yes" serves as a release for my child/children to appear in photographs and/or video while participating in the above stated program/activity. These photos may appear in other promotional materials. If you do not wish to have your child/children's picture taken and used for the above purposes please email us at [email protected] so we can make sure your request is taken care of.