This health history is correct, so far as I know. I hereby give my permission to the physician, nurse, or emergency medical provider selected by Grace Bible Church to secure medical or dental aid as required for illness or injury under a physician's orders, including transportation to and from the necessary facilities. As a participant, I understand that Grace Bible Church is not obligated to carry any insurance to cover those medical/dental expenses. If such insurance is carried, coverage will be provided ONLY for expenses in excess of the limits of the participant's insurance. I understand that my personal insurance is my primary coverage.