By typing my name in the box below, I do hereby give consent to any medical, dental, or surgical treatment that the Parkgate Student Ministry Pastor and/or Adult Leaders from Parkgate Community Church, 3715 Preston Road, Pasadena, TX 77505 may deem necessary while participating in the below mentioned Parkgate Student Ministry sponsored activity. I understand that every conceivable effort will be made to contact me, the parent or legal guardian of the above mentioned student, before treatment is given. I do hereby assume all risks and I agree to release and hold harmless Parkgate Community Church of Pasadena, TX, its representatives, employees, and all related entities from any liability, loss or damage actions, claims and demands, which my child now has or that may arise from their participation in this activity.