WAIVER OF LIABILITY, ASSUMPTION OF RISK & INDEMNITY AGREEMENT
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Child Name
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Date of Birth
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Child Name
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Date of Birth
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Day
Year
Date
Child Name
First Name
Last Name
Date of Birth
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Month
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Year
Date
Child Name
First Name
Last Name
Date of Birth
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Month
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Day
Year
Date
Adult
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Adult
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Publicity/Privacy Release
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Day
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Date
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Emergency Contact (If different than Parent)
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