I/We, the undersigned certify that I/we am/ are the legal parent(s)/guardian(s) of the above named participant and as such grant permission for the same to participate in the aforementioned activity/event.

I/We have been advised of the nature and extent of the activities that may take place and represent to you that the participant is physically and mentally able to participate in these activities. 

I/We understand that the activity does present risk of injury or even death to the participant and have advised the participant of these possibilities. I/We represent to you that I/we and the participant assume all risk both financial and physical from any such injury or death and hold you, your agents, employees and representatives harmless from any liability for injury or death to the participant while engaged in the activity which may or may not be caused or contributed to by the conduct of the participant or accident related to activity  and agree to indemnify and defend you against any claim or liability asserted against you for any such injury or death to participant.

I/We also hold you, your agents,employees and representatives harmless from all liability to any other person or entity arising as a result of the conduct of the participant  or accident related to this activity and agree to defend and indemnify you, your agents, employees and representatives against any claim or liability arising as a result of such conduct. 

If I/we are not personally present at these activities in which the participant is to participate, so as to be consulted in the case of necessity, you are authorized on our behalf to arrange for such medical and hospital treatment as may deem advisable for the health and well being of the participant and that I/we, as parent(s)/guardian(s) accept financial responsibility for such treatment. 

I/We also agree to transportation as arranged by the representatives of the Pentecostal Family Church in Cleburne Texas.

As a particpant, I understand and agree to abide by all rules including those of saftey and conduct as laid out by the Pastor, sponsors, and chaperones of the Pentecostal Family Church.