By checking this box and signing the electronic signature below, I, the parent or legal guardian of the minor child(ren) listed above, give my consent for emergency medical and surgical treatment of this minor/these minors in a licensed hospital by a licensed Pennsylvania physician should his/her condition so require it in my absence. I understand that in such a case reasonable attempts would first be made to contact me, time and conditions permitting. As long as the medical or surgical treatment is considered necessary and the situation is in accordance with generally accepted standards of medical practice for the particular type of injury or illness involved, I impose no specific limitations regarding treatment other than those that follow: (if none, so state.)

By submitting this form, I am signing this agreement electronically. I agree that my electronic signature is the legal equivalent of my manual signature. By selecting "I Accept" I consent to be legally bound by this agreement's terms and conditions. I further agree that my use of a key pad, mouse or other device to select an item, button, icon or similar act/action, or to otherwise provide Walnut Creek Baptist Church instructions via its online portal or in accessing or making any transaction regarding any agreement, acknowledgement, consent terms, disclosures or conditions constitutes my signature (hereafter referred to as "E-Signature"), acceptance and agreement as if actually signed by me in writing. I also agree that the validity of my E-Signature shall be determined under the laws of the State of Pennsylvania and that no certification authority or other third party verification is necessary to validate my E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of my E-Signature or any resulting contract between me and Walnut Creek Baptist Church. I also represent that I am authorized to enter into and or submit this agreement for all persons in my household that are members or participants in Walnut Creek Baptist Church's AWANA program and that such person(s) will be bound by the terms of this Agreement.