I understand that in the event medical intervention is needed, every attempt will be made to contact immediately the persons listed on this form. In the event I cannot be reached in an emergency during the dates shown on this form, I hereby give permission to the physician or dentist selected by the activity leader to hospitalize, to secure medical treatment and/or to order an injection, anesthesia, or surgery for my child if deemed necessary. I understand that my insurance coverage for my child will be used as primary coverage in the event medical intervention is needed. Coverage by Pinehill Baptist Retreat through its accident policy will be used as a backup for what my family’s insurance does not cover. I understand all reasonable safety precautions will be taken at all times by Pinehill Baptist Retreat and its agents during the events and activities. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree not to hold Pinehill Baptist Retreat, its leaders, employees, and volunteer staff liable for damages, losses, diseases, or injuries incurred by the subject of this form. I consent to the use of video images, photographs, audio recording, or any other visual or audio reproduction that may be taken of the subject of this release during the activity/event to be used, distributed, or shown as Pinehill Baptist Retreat sees fit. I have reviewed the information about the summer program of Pinehill Baptist Retreat and give my permission for the subject of this release to be involved in the overall activities.