By my signature below, I, First Name Last Name , as parent and / or legal guardian give permission for First Name Last Name , a minor, to attend and receive skilled physical therapy treatments at Agility Physical Therapy and Sports Rehabilitation, LLC with and without a parent or legal guardian in attendance.I understand that Agility Physical Therapy and Sports Rehabilitation, LLC strongly advises a parent or legal guardian to be present at all times, but especially for all evaluations and for any treatments that include the anterior chest (shoulders, neck) on females, and pelvic area (lumbar spine, sacrum, hips) on all minors.By my signature below, I release Agility Physical Therapy and Sports Rehabilitation, LLC and all staff from the responsibility of supervising my child in the public areas of the building complex.