I hereby allow my child/children to participate in the Parents Night Out and assume all risks and, in consideration of his/her participation in the said program do hereby waive and release all claims arising as a result of personal injures or property loss during the program. I furthermore authorize the staff program in the event of illness or injury to administer emergency care and to arrange for any medical transportation to the nearest health care facility deemed appropriate. I understand every effort will be made to contact the parent or guardian prior to any involved treatment. I grant permission to a qualified physician and/or other medical personnel to furnish medical care using the above guidelines while my child/children attend Parents Night Out. I also agree that my insurance carrier or I will bear the financial responsibility for any medical treatment administered under the above guidelines.