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June 28, 2012 My child, has permission to attend the event at Six Flags New England in Agawam, MA. I understand that every effort will be made to protect and safeguard all participants. Therefore, I agree not to hold Bethany Church or any of its staff and chaperones liable for any illness or mishap occurring in transport to and/or during the event. I understand that adult supervision is being provided for the event and I authorize any treatment by an accredited hospital and/or physician if it is deemed necessary for my child. I understand I will be responsible for picking up my child at any time if my child becomes unruly. Parent/Guardian signature (date) phone