I authorize the leader(s) in charge of the above-mentioned group where it is impractical to communicate with me, to arrange for my child to receive such medical or surgical treatment as the leader(s) may deem necessary at any time during the activities of United Lutheran Church. I further authorize the use of ambulance and/or anesthetic by a qualified medical practitioner if in his/her judgment it is necessary. I accept responsibility for payment of all expenses associated with such treatment. I appreciate that every care will be taken by the leaders and recognize that those connected with that group cannot be held responsible for personal injury, loss, or theft or property affecting my child.