2024 Individual Liability Release

Select Member Club (Club of Host for Guests)

Crescenta ValleyPanoramaCanyon OaksSan FernandoGopher FlatsGuest
Guest of whom (Host)
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Address

Street Address

Street Address Line 2

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Zip
Phone Number
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Email
example@example.com
SIGNATURE[acknowledges pages 1 and 2] [If you are under 18 years old, we need the signature of a parent of guardian.]
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Date

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Date
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