In the event of accident, injury or illness involving any child of mine (specifically including my child named above as the "Participant") or me or my spouse while in, on, or about the premises of Texas Sailing Association (the 'Club') or while participating in any activity sponsored by or under the auspices of said Club under circumstances where I am physically unable to consent or am not present,
I hereby voluntarily authorize and consent to the furnishing to myself, my spouse, or any child of mine of such medical care, attention, and treatment by any hospital, physician or dentist as such hospital, physician or dentist may deem necessary or advisable, including any x-ray examination, anesthetic, medical, or surgical diagnosis or procedure.
I authorize any adult associated with the activity to consent to such medical care, attention and treatment.
I agree to pay the reasonable cost of such medical care, attention or treatment and to indemnify and hold free and harmless of and from any and all liability for such cost the assisting adult, the Club, its officers, employees and members of said organizations. It is understood that effort shall be made to contact the undersigned prior to rendering treatment to the patient, but that any of the above treatment will not be withheld if the guardian cannot be reached.
This consent shall be valid for one (1) year from the date of signing.