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Parent/Student Liability Waiver
Student First Name
Student Date of Birth
Do you have a doctor’s permit to participate in intense physical activities?
Please specify any allegeries we should know about
I declare that the info I’ve provided is accurate & complete
I hereby acknowledge this release from liability for accidental injury or illness which my student may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.
Thanks for submitting!