I agree that my child, named above, may participate in the St. Anthony of Padua Summer Art Camp. In consideration of participation in this event, I agree, on behalf of the above-named child, to fully and forever release, discharge, indemnify, and hold harmless the Archdiocese of Galveston-Houston, Cardinal Daniel DiNardo, St. Anthony of Padua Catholic Church, St. Anthony of Padua Catholic School, its agents, servants and employees from and against any and all losses, costs and expenses including, but not limited to attorney's fees, damages and expenses and liability (including statutory liability and liability under worker's compesation laws) in connection with claims for damage as result of injury, disability or death of any person or damages to property, present or future, whether the same be known, anticipated or unanticipated, resuting from or arising out of participation in the referenced event. I hereby authorize in advance any medical treatment required by the above-named child participating in this camp. I also acknowledge that I have/will notify the camp director, Suzanne Ettman, of any special medical needs or information required by the above-named child. In the event of a serious medical emergency, I hereby consent to and authorize treatment for my child by medical personnel until I can be contacted.

In understand that my FACTS account will be charged for the full, non-refundable amount of $275 before the first day of camp.

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THATWILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.