As the parent or legal guardian, I have described all medical conditions which could limit my child from being able to fully enjoy and experience Cornerstone's activities. The person herein described has permission to engage in all prescribed camp activities except as noted to me. I hereby give permission to the physician selected by the school teacher or Cornerstone staff to order x-rays, routine test, and treatment for the health of my child, and in the event I cannot be reached in an emergency, I hereby give permission to the physician selected by the school teacher or Cornerstone Staff to hospitalize, secure proper treatment for, and to order injection and/or anesthesia and/or surgery for my child as named above. It is expressly understood and agreed that Cornerstone shall not be responsible or legally liable for any losses of personal property or for any bodily injuries, or the results thereof, incurred and suffered by the applicant or in connection with any activities or programs, unless such loss or injury results directly from the negligent or willful act of an employee of Cornerstone acting within the scope of his/her employment. I grant permission for image and likeness (i.e. photo, name, quotes) of my child to be used in publications by the institute.
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