"In God Nothing Is Too Extreme "

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* 1. Youth First Name and Last Name

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* 2. Youth birth month/day/year

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* 3. Address 

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* 4. Childs Allergies/Needs

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* 5. Additional Information

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* 6. The child named above is in good health and I consider him/her capable of the activities taking place.  I agree to him/her taking part in youth activities.  In the event of a accident I consent to any necessary medical treatment.  In a emergency I consent to treatment by medical health professionals, if considered. 

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* 7. I also give permission for photos/videos for local promotion to be taken.  (Children will not be identified by name)

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* 8. Emergency Contact Name

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* 9. Emergency Contact Mobile Number

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