The health information provided is correct and complete to the best of my knowledge and belief. The child herein described has parental/legal guardian permission to engage in all program activities. I hereby give permission to Noggin Builders, LLC to provide emergency care and seek emergency medical, surgical, or dental treatment including ordering x-rays or routine tests. I agree to the release of any records necessary for payment, treatment, or insurance purposes. In the event of an emergency, I give permission to Noggin Builders, LLC to arrange necessary related transportation for my child. In the event that I cannot be reached in an emergency, I hereby give permission to the physician/health care provider selected by Noggin Builders, LLC to secure and administer treatment, including hospitalization, for the person named above. This completed form may be photocopied, if needed. I understand that the child(ren) named herein will be participating in programs and activities at Noggin Builders, LLC. I acknowledge that such programs and activities involve inherent risks. I release and forever discharge and indemnify Noggin Builders, LLC and its employees, members, officers, agents, and representatives from any and all damages and causes of action including attorney's fees as a result of my child(ren)’s participation in any activities at or associated with Noggin Builders, LLC. I give my permission to Noggin Builders, LLC to use any video or photograph, either online or in print, or any video taken at the event my child is attending for the purpose of marketing or promoting Noggin Builders, LLC and its programs.