In consideration of participation in this clinic, I agree, on behalf of the above named child, his/her heirs and representative to fully and forever release, discharge, indemnify and hold harmless MADFROG LLC, its agents, servants and employees from any and all claims, demands, damages, rights of action or causes of action, present or future, whether the same be known, anticipated or unanticipated, resulting from or arising out of participation in this event. I HEREBY AUTHORIZE IN ADVANCE ANY NECESSARY MEDICAL TREATMENT REQUIRED BY THE ABOVE NAMED CHILD WHILE IN ATTENDANCE OF THIS CLINIC. I ALSO ACKNOWLEDGE THAT I HAVE/WILL NOTIFY THE CLINIC PERSONNEL OF ANY SPECIAL MEDICAL NEEDS OR INFORMATION REQUIRED BY THE ABOVE NAMED CHILD.