I have read and fully understand the contents of this form. I have completed the form to the best of my knowledge and ability. I understand that if any information listed in this form changes, I will notify GIRLS PLACE immediately. The child/children listed above has/have my permission to participate in the activities sponsored by GIRLS PLACE as noted on the program schedules. In the case of an emergency an alternate person will be called if the parent(s) can not be reached by phone. The undersigned, individually and as parent or guardian of the participant, hereby authorize GIRLS PLACE to carry out any measures deemed necessary should an emergency occur, including at the expense of the undersigned, appropriate medical treatment for the participant, and hereby releases the GIRLS PLACE, its employees and agents, from any liability or claims arising out of the participant's engagement in the above described events. My full name entered above serves as my digital signature.