I hereby certify that all the information included in Medical History and Release Form is complete and accurate to the best of my knowledge. I hereby certify that to the best of my knowledge I am in a state of health sufficient for me to take part in any of the activities sponsored by BSM without jeopardizing my well-being. I am aware that when taking part in activities like this there may be risks and dangers which I will assume personal responsibility for and will release and agree to indemnify and hold harmless BSM, its officers and directors, employees, and any parties volunteering on behalf of BSM, from all actions, costs, expenses or damages of any kind growing out of or related to any activities or transportation to and from the activities. I hereby authorize the BSM to take my photograph for use in BSM publications and/or future promotional materials.