The Health History is correct so far as I know, and the person herein described has permission to engage in all prescribed activities except as noted. Emergency Authorization - I hereby give permission to medical personnel selected by The Summit Church/event staff to order X-rays, routine tests, and treatment for my student. In the event of an emergency, if neither my primary contact nor secondary can be reached, I hereby give permission to the physician selected by the Authorized Agent to hospitalize, secure proper treatment, order injections and/or anesthesia and/or surgery to my student. I further authorize the release of the above medical information to appropriate medical personnel and/or the health coverage insurance company. In addition, I have, and do hereby, release The Summit Church, its employees or agents from liability associated with participation in a church activity. I understand that if I do not have medical insurance, I, as the parent or guardian, will be responsible for any medical expenses in the event of a sickness and/or injury. I understand that there are risks involved in taking place in recreation activities and other activities related to participation in youth functions