I have completed the health history to the best of my knowledge. The person herein described has permission to engage in all activities. I consent for myself or (for a minor participant) my child to receive such medical treatment as deemed necessary in an emergency and to assume liability for any medical expenses. Should a medical emergency arise in the case of a minor, I understand BPS staff and volunteers will make reasonable efforts to contact me or my designated alternate at the phone numbers I have given. I/we release the staff, volunteers, and the Belleville Philharmonic Society (BPS) from any liability arising from participation in the Belleville Philharmonic Youth Orchestra. Parents of youth – I/we further understand and agree that I/we assume full responsibility for any loss or damage to property or bodily injury to others caused by the participant, whether by accident or intent. I/we also understand that if the behavior of this participant becomes inappropriate, I/we will be responsible for immediate transportation home. MEDIA PERMISSION When participating in Belleville Philharmonic activities, I may be photographed for print, videotaped, or electronically imaged. Images and/or videos may be used in promotional materials, news releases, and other published formats for the Belleville Philharmonic Society and will be the sole property of the organization.