IMPORTANT - MUST BE COMPLETED FOR ATTENDANCE: To my knowledge, this health history is correct and complete. The person described and named above has permission to engage in all retreat activities except as noted. I give permission to Missouri Union Presbytery to provide routine health care, administer prescribed medications or Tylenol/Advil if needed, and seek emergency medical treatment including ordering x-rays or routine tests. I agree to the release of any records necessary for treatment, referral, billing, or insurance purposes. I give permission to Missouri Union Presbytery to arrange related transportation for me/my child. In the event I cannot be reached in an emergency, I also give permission to the physician selected by the Presbytery to secure and administer treatment, including hospitalization, for the person named above. This form may be photocopied for use of transportation. I give permission for my child/me to participate in all regular event activities and for pictures taken of me and/or my child during the retreat to be used for presbytery publicity, including but not limited to website or social media.