In signing this form I release all liability from Kelly Neumann and Kinematics with Kelly in case of injury from participation in Movement Clinic. I give permission to Kelly Neumann to administer any necessary medical attention to my son/daughter/self in case of injury. I will be notified immediately at above listed number and emergency contact if such an occasion occurs. If unable to reach me, I give permission to do what is in the best interest of my son/daughter until I am notified. I also understand that my insurance company or I will accept all medical expenses.