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End of Summer Pool Party 2019
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Patient's Name
*
Your answer
Number of Attendees
*
Your answer
Swimmer vs. Non-swimmer
*
Swimmer
Non-swimmer
Patient's Contact and Phone #
*
Your answer
Have You Completed Your Waiver for Villasport?
*
ALL attendees must have their own waiver signed and completed PRIOR to event, or no entry. (ie; parent and child will each need one)
Yes
No
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