Youth Lead Liability Form
Name of Minor
*
First Name
Last Name
USA Contact #1
*
Relationship to Participant
*
USA Contact #1 Email
example@example.com
USA Contact #1 Phone
*
Please enter a valid phone number.
USA Contact #1 Address
*
USA Contact #2
Relationship to Participant
USA Contact #2 Email
example@example.com
USA Contact #2 Phone
Please enter a valid phone number.
USA Contact #2 Address
India Contact #1
Relationship to Participant
India Contact #1 Email
example@example.com
India Contact #1 Phone
Please enter a valid phone number.
India Contact #1 Address
Name of Parent/Guardian
*
Relationship to Minor
*
Parent/Guardian Signature (Image file under 1 MB)
*
Browse Signature
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