(My child) 

has my permission to participate in the activities at the Rick Johansen / Texas Wesleyan University Volleyball camp.  In consideration of my child's attendance at Camp, I understand I am accepting full responsibility for my child.  If an accident should occur injuring my child, including, but not limited to, death or serious injury, I on behalf of myself, my heirs or successors, hereby release Rick Johansen / Texas Wesleyan University, and their trustees, directors, officers, agents, employees, counselors, or students from any liability.  I understand that any expenses incurred for medical treatment of my child will be my responsibility.  I agree on behalf of myself and my heirs and successors to indemnify and hold harmless Rick Johansen / Texas Wesleyan University from any loss, cost, judgment, or other harm, including attorney fees, which might come to the arising from my child's attendance at the Rick Johansen / Texas Wesleyan University Volleyball camp.  I grant permission for the Rick Johansen / Texas Wesleyan University to photograph, record, or video my child during Camp and to use those materials for promotional or other purposes.       

I hereby give permission to the Rick Johansen / Texas Wesleyan University volleyball camp to make any and all arrangements deemed appropriate and in the best interests of my child for medical, surgical, and dental care.  In the event I cannot be reached in an emergency.  I hereby give permission to a health care provider to secure and administer treatment, including hospitalization, for my child.  I understand that parental permission is required for operative procedures on minors.  By signing this form, I am giving my permission that operative procedures may be promptly carried out.  I understand that the Rick Johansen / Texas Wesleyan University Volleyball camp is not responsible for my child's pre-existing injuries or illnesses or any aggravation of these conditions.  In understand that the Rick Johansen / Texas Wesleyan University Volleyball camp will not assume responsibilities for illness or injury incurred while my child is participating in Camp activities.  I authorize release of any medical information to process insurance claims and request payment of benefits of the physicians or supplier for service.