For all activities sponsored by Reality Church Stockton on July 20, 2023 - July 23, 2023.

The undersigned, parent/legal guardian of (minor), herein authorize the adult sponsor of Reality Church Stockton for the stated activity(ies) or any responsible adult person bearing this written authorization, into whose said care the above mentioned minor child has been entrusted to consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital care to be rendered to said minor under the general or special supervision and upon the advice of a physician and surgeon licensed under the provisions of the California Family Code.

It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required, but is given to provide authority and power on the part of said adult person to give specific consent to any and all such diagnosis, treatment or hospital care which the aforementioned physician or dentist in the exercise of his best judgement may deem advisable.

This authorization will begin on July 20, 2023, at 830 am, and will remain in effect until the group returns, unless sooner revoked in writing and delivered to the adult sponsor.