SIDELINE CANCER "DREAM" CLINIC - JUNE 3RD
FREE SUMMER BASKETBALL SKILLS CLINIC TO HONOR LUANNE VARACALLO
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Email *
SIDELINE CANCER "DREAM" CLINIC FLYER
Child's Full Name *
Child's Age *
Parent/Guardian Full Name *
Parent/Guardian Phone Number *
Participant's Address (Street, City, State) *
Participant's Current School and Grade *
I hereby certify that I am (or my minor/child is) in good physical and health condition and will assume all risks and liabilities related to my (his/her) participation in the Sideline Cancer "Dream" Skills Clinic. I hereby release all claims of damage or suit I may have against Sideline Cancer, DuBois Dream, DuBois Christian Schools, as well as all other coaches, organizers, participants or volunteers that are helping or involved with the Clinic and agree to adhere to the health and safety protocols put in place. *
Emergency Contact - Name and Phone *
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