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General Liability Form
Student First name
Student Last name
Parent Email
Parent Phone Number
Birthday
Month
Address
Please acknowledge any food related allergies.
In case of emergency who should be contacted?
General Release and Waiver of Liability. I hereby acknowledge that I am allowing my child to participate in the GRACED FIXINS LLC program. I hereby assume full responsibility, liability and risk…
Clear
Wavier continued… I understand that in case of a medical emergency, my own personal medical plan will be used if available. In the event of any illness or injury, I hereby consent to whatever examination, diagnosis, or treatment and the hospital care from
Clear
Wavier continued… a licensed dentist, physician, and/or surgeon as deemed necessary for my child’s safety and welfare. I understand that the resulting expenses will be my responsibility and not the GRACED FIXINS LLC, or any affiliates.
Clear
Wavier continued… As a condition of participation in the GRACED FIXINS LLC program by the student named in this application, I acknowledge that I have read this consent form, and knowingly, on behalf of my child, assume all of the risks associated…
Clear
Wavier continued… with participating in any way in the GRACED FIXINS LLC program. By signing below, I agree that I have read and understand the General Release and Waiver of Liability.
Clear
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