Parents, please be aware your child may be photographed during the week of Agency D3! Photos will be used for Sovereign Grace Church's promotional purposes ONLY. Please indicate consent below.

I hereby release, forever discharge and agree to hold harmless, Sovereign Grace Church of Pasadena, its elders, directors, employees and volunteers, from all liability, claims, or demands for personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the above named child that occur during any activities. Furthermore, I hereby assume all risk of personal injury, sickness, death, damage and expense as a result of participation in these activities. The undersigned further agrees to hold harmless and indemnify Sovereign Grace Church of Pasadena, its elders, directors, employees and volunteers, for any liability sustained by said church as the result. I, as the parent or legal guardian of the child listed on this form herein authorize the adult sponsor of Sovereign Grace Church of Pasadena to consent to any X-ray, examination, anesthetic, medical or surgical diagnosis or treatment, on the advice of any physician or surgeon licensed to practice in the state of treatment, when the need for such treatment is immediate, and when efforts to contact me are unsuccessful. Please sign consent below.