ࡱ> ,.+q`  bjbjqPqP .::  ~$h B^^^~^~^^^ e4o7^~0^_ ,_ ^_ ^ ^H$ Twin Ponds Family Recreation Centers Medical & Liability Release Statement Please Read Carefully: By signing my name to the Waiver Form below provided by Twin Ponds, I release Twin Ponds Family Recreation Centers from any claims or responsibilities for injuries suffered in this scheduled event. I knowingly assume all risks associated with my participation, even if arising from negligence of others, and assume full responsibility for my behavior. I certify that I am at least 18 years of age, in good physical condition, and can participate in lacrosse. If I am under 18 years of age, I have parental/guardian consent and a parental/guardian signature on the Twin Ponds waiver form. Further, I authorize the site director to request medical treatment as necessary to insure my safety. Also by signing the Twin Ponds Waiver Form, I take all responsibility for knowing and abiding by the rules and regulations of Twin Ponds Family Recreation Centers. If I do not abide by the rules of Twin Ponds recreation centers, I risk being banned from the facility. If in agreement with the Medical and Liability Release Statement above, please sign below. Your signature indicates that you are in agreement with the Twin Ponds Policy. ___________________________________________ _____________ Signature of Participant (if over 18 years of age) Date ___________________________________________ _____________ Signature of Parent/Guardian if under 18 years of age Date  ':;LMNg 9 D E % & (  ˻h:h:CJaJh:CJaJh:5CJaJ h:56h:hh5CJ aJ h:5CJ$aJ$h5CJ$aJ$ h56h56CJ4aJ4 %&';MNefg  & ' (  S T U gd$a$gd:$a$gd ,1h/ =!"#$% @@@ NormalCJ_HaJmH sH tH DA@D Default Paragraph FontRiR  Table Normal4 l4a (k(No List %&';MNefg&'(STU0000000000000000000000000   CL;MLLCL:@LL LLP@UnknownGz Times New Roman5Symbol3& z Arial"hll  !r42HP)?2 Twin Ponds  Oh+'0h  $ 0 <HPX` Twin Ponds Normal 1Microsoft Office Word@캃@`l7@~o7՜.+,0 hp|      Twin Ponds Title  !"$%&'()*-Root Entry F !Bo7/Data  1TableWordDocument.SummaryInformation(DocumentSummaryInformation8#CompObjq  FMicrosoft Office Word Document MSWordDocWord.Document.89q