By clicking the box below, I, the parent/guardian of the above named child, do hereby grant permission for my child, named above, to attend the program indicated on this form. I authorize the Mega staff to obtain and/or provide medical treatment for my child during the time he/she is present at the program, and I hereby hold the Mega staff and volunteers, Northgate Church as well as their representatives, harmless in the exercise of this authority. I further understand that the possibility of injury or illness exists for my child while at the program, and I hereby authorize the Mega staff and representatives to refer my child to a medical treatment center or hospital. I acknowledge and understand that I will be responsible for any medical bills incurred on behalf of my child for illness or injury they may sustain during the Mega program. Understanding that there is always a possibility that my child may sustain illness or injury, I acknowledge and understand that my child is assuming the risk of physical injury or illness by his/her participation, and I further release Northgate Church and its representatives and volunteers from any claims for personal illness and/or injury that my child may sustain during the Mega program. I further acknowledge and understand that my child will be responsible for his/her failure to abide by the rules and regulations of the specific Mega he/she is attending. I attest that the information provided in this application is complete and accurate, and agree to inform Mega staff immediately should any information change from what is listed on this form.

I give permission for my child to be photographed and videotaped and for these images to be used during the Mega program and for future promotional material.