ࡱ> $&#Q@  bjbj͘ "0000000D(((( 4 Do LLLLL'''WYYY/44 $% Rw 0''''' 00LL) ''''0L0LW''W' '3003L@ @('3W? 0o 3'3DD000003$''''  DD('DD(South Windsor Soccer Club, Inc. Consent for Transportation The undersigned parent or legal guardian of minor ______________________________ do hereby authorize the officer, leader, coach, or agent of the state youth association to transport as required the above minor to and from association sponsored activities including but not limited to athletic and social events. Signature of parent/guardian: ______________________________ Date: ____________ Consent for Medical Treatment of Minor I hereby give consent for all medical care prescribed by a duly licensed doctor of medicine for _________________________ as his/her parent or legal guardian. This care may be given under whatever conditions are necessary to preserve the life, limb, or well being of my dependent. Signature of parent/guardian: ______________________________ Date: ____________ Address:____________________________________________ Phone: ______________ Insurance Co.: _________________ Group No.:________ Policy No.: _______________ Our physician is: ______________________________________ Phone: _____________ Known Allergies: _________________________________________________________ Our dentist is: ________________________________________ Phone: _____________ Revised March 5, 2001  : hsCJaJhs5>*CJ\aJhsCJaJhs56CJ\]aJ ;s  U ? $da$$da$d$da$  P/ =!"#$%>@> Normal7$8$_HmH sH tH DA@D Default Paragraph FontRiR  Table Normal4 l4a (k@(No List  ;sU?0000x0x0x0x0x0x000x000x0x0x   8@0(  B S  ? ~[Ls@HP DeskJet 710CLPT1:winspoolHP DeskJet 710CHP DeskJet 710C,LetterDINU"4$@$$$$$HP DeskJet 710C,LetterDINU"4$@$$$$$4p@UnknownGz Times New Roman5Symbol3& z Arial"h33#xx43?South Windsor Soccer Club, IncPreferred Customer Oh+'0 ( D P \hpxSouth Windsor Soccer Club, IncoutPreferred CustomerrrefrefNormale rm2rmMicrosoft Word 10.0@F#@V@V3՜.+,0  hp  Dell Computer CorporationcA South Windsor Soccer Club, Inc Title  !"%Root Entry F '1Table WordDocument"SummaryInformation(DocumentSummaryInformation8CompObjj  FMicrosoft Word Document MSWordDocWord.Document.89q