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Please insert your child's name as it will appear on his/her name badge.
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Please insert your child's name as it will appear on his/her name badge.
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We take your privacy very seriously and do not distribute any personal information in any way.
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Please insert your child's name as it will appear on his/her name badge.
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We take your privacy very seriously and do not distribute any personal information in any way.
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Please insert your child's name as it will appear on his/her name badge.
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We take your privacy very seriously and do not distribute any personal information in any way.
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Medical Release Form
Event: Northwest Presbyterian Church SonRise National Park VBS 2012
I/we the undersigned parent(s) or guardian(s) of the child listed above, a minor, do hereby authorize the volunteers of Northwest Presbyterian Church, Inc. as agents for the undersigned, to consent to any medical or surgical care deemed advisable by any accredited physician or sugeon in an approved emergency clinic or hospital.
I further release from any liability Northwest Presbyterian Church, Inc. and any of its ministries, leaders, or volunteers in the event of an accident en route, during, and returning from the above mentioned event.
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By inserting my FULL LEGAL NAME here, I am digitally signing this Medical Release Form.
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BY INSERTING THE LAST 4 DIGITS OF MY SOCIAL SECURITY NUMBER, I AM VERIFYING MY DIGITAL SIGNATURE ABOVE.
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