BY CHECKING THE BOX TO THE LEFT, YOU ARE AGREEING TO THE FOLLOWING:

In the event my child becomes ill or injured while under SAINTS supervision, I/we approve authorities to take the following steps:

1. Contact a parent/guardian of the student and follow his/her instructions.

2. In the event neither parent(s) nor guardian(s) can be reached, contact the physician and follow his/her instructions.

STATEMENT OF RELEASE

I/We the undersigned hereby grant the above named student(s) permission to participate in SAINTS of Florida, Inc. (SAINTS) sponsored activities. I/We release and hold harmless SAINTS and its staff from all liability for mishap or injury to the student(s) named herein from the time of drop off to the time of pick up. In the event my child(ren) need(s) medical/surgical services which require my consent before being applied and I/we cannot be reached, I/we hereby authorize, appoint, and empower a SAINTS representative to furnish on my/our behalf such written or oral authorization as may be required. It is understood the best possible care will be given to my child(ren).

**Photo Release.

The undersigned also authorizes the filming, photographing, and recording of child(ren)s voice or likeness and the use of child(ren)s first name for all lawful purposes in connection with the specific activities of SAINTS.

In rare cases, some parents prefer that their children are not photographed at Saints. If this is the case, please contact Coach Rick Andreassen for a photography addendum.

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