PARTICIPANT INFORMATION:


    I am under the age of 18 years old.


FOR PARTICIPANTS UNDER THE AGE OF 18 YEARS OLD:

This is to certify that I, as a Parent, Guardian, Temporary Guardian with legal responsibility for this participant, do consent and agree not only to his/her release of all Releasees, but also to release and indemnify the Releasees from any and all liabilities incident to his/her involvement in these programs for myself, my heirs, assigns, and next of kin.





    I acknowledge that I have completed this information accurately and Today's Effective Date is 08/18/2018.







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