Birdies Social
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Birdies Social - Waiver Form
First Name
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Last Name
*
Email Address
*
Phone Number
*
Street Address
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Home City
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State
*
Zip Code
*
Birthday
*
Signature
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Child's Name
Child's Date of Birth
Child's Relation to Parent/Guardian
Child's City
Child's Street Address
Child's State
Child's ZipCode
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Release of Liability
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First Name
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Email Address
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Phone Number
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Street Address
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Home City
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State
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Zip Code
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Birthday
Signature