ࡱ> ?A>%` bjbjNN .,, -z-|-|-|-|-|-|-$.h1---  z- z-   0BF z--0- 1 v1 1 # -- -D Registration and Medical Information/Release Form Childs Name: ___________________________________ Phone:__________________ Address: _________________________________________ Mother: _____________________________ Day phone:__________________________ Father: ______________________________ Day phone:__________________________ Email Address to be used for information during season: __________________________ Emergency Contract: _____________________________ Phone:___________________ Allergies: _______________________________________________________________ Any other information Advisors should be aware of: ______________________________ _______________________________________________________________________ Family Doctor: __________________________________ Phone: __________________ Hospital: ________________________________________________________________ Insurance Policy: ________________________________ Number: __________________ Your signature below gives the Advisors and Board Members of the Bridgewater Badger Cheerleaders permission to authorize medical treatment and to release medical information as needed to medical personnel. I, ____________________________________________, the undersigned, being theParent/legal guardian of _________________________________________, authorize the Bridgewater Badger Cheerleaders Advisors and Board Members to authorize medical treatment for my daughter if injured or ill while under the supervision of the Advisors or Board Members. __________________________________ _________________________ Parents Signature Date 2  # ' Z ^ ԿhPthxCJaJ#hPtB*CJOJQJ^JaJph)hPthPtB*CJOJQJ^JaJph)hPthMB*CJOJQJ^JaJph-hPthM0JB*CJOJQJ^JaJph'hM0JB*CJOJQJ^JaJph36  R T B E / 1 | ~ xgdM $xa$gdM LxgdPtxgdM,1h/ =!"#$% @`@ MNormalCJ_HaJmH sH tH DA@D Default Paragraph FontRi@R  Table Normal4 l4a (k@(No List o Mu1>*36RTBE/1|~L0000000000000000000000000000000000LZ00X00X00 00   mo6833333 #'Z^" D "'39N9PwxRW\t~#PQ0ZlB{-%+R,<HMh*.CHFKM[_eRq$*,'/4OBSJb /".BTkaEg !Y04D>HXQl|3W[[_CgSgxy#[#%%%Z-A,CEZBlw~ 8 " q( ) 8 ; ? I R ^ #d d  " 0 IB @G &W o G \$ ) IH N 'Z "\ i k r |  & ) ,? F /G FV _] f g l ; < pC G T u] z `{ Lr w0<s[fex?+029@R,S)Vlc S^*+q3@Zpsu+&'=+1<yA,lnv~ J )F#\ox#F(9?-@ICJ}UeyDaY1::HW'7AFD[2g)ydw27@d[\^iyq|r|z/ e&4w45 Gc(U26;}DDGJTtZ5jsa(O]iv~ CF|[Kqzz>,,<jUaXj!#EAF]%mptz'H"Q"-d;DRo]em+wNy+ [jiFqv{  K  ; E hc t cy !`!!!0 !"!k/!?!sQ!d!4h!" "-":1"1"<"# #o###a;#S#i#pv#v#Gy# .$6$<@$F$xG$H$7f$o$9z$?$B%M%Q%W%o%x%&#&&+)&f4&6&_&h&l&p&|''' 'F>?>>>?>i>k>l>Wn>hn>^u>?>&?m)?4?oE?!f?Ug?ml?rp?@@o0@0@6@*;@;@cA@uA@Q@CW@W@X[@k@q@bz@}@A3A.AU?UPEURU:jU}qUvUzUVWVVWOVPVo`VrVrVwV WWWl;WCWEWjWWX)X1X7X7:XPXOYX]XoXz Y]h?] w]m{]|]^-&^{/^H^=I^J^5L^~_O__A._?_H_!I_8]_'g_p_ `9` "`I`U`Z`6a $al?amKaKaSaTa.raHsaJta-xab bbbH-bL/b2b:ba;bGbc ccc cr$c)c/c;cAcJcvbcQec'd2dBd:QdTd6gdzd,~ddteeM=eVe>eefe/qeveze_{ef5f-WfZf[f_fnf"gO ggfg|%gO.gX9gh)YhOnhai)i{*iV7i8iOi]TiXijimivi^xij,j0jCjvGjTj_j#fj9k|k/&k4k7kCkVkYkjkjk ll&l)l+l=lE>lBlNl7Tl^lll=nlwl[|lm*%m*mM,mmm)qm:umdxmnn!n9n,FnGnSn?_nvnn%o)ow6oAoPGoypEppD&p+p0pqp`}pq#q2q>qzLq4aqaq hqkqoq;yqu~qrrrr*r:rkr{r,s/sRsj^sfs t6 tDt#t&tAtPt:ytp{t}t}tu|uu#1uTuuWuYtuvv5+vKvQv0Svtvwvyvw%w+wVw{bw|qwxxxx7:xEKxhkxqxwx{xyjy-y2yL3y\|>|@|S|_|d|j|Sw|`~|}};}L}D^}j_}a}f} ~o~u~l"~G/IWp]_`owx )/1k3=ee t~ #e9DFQ|^Ujv n\3MMO]Qty\ \08NRnz&=&P(^-5ImY 9s7+W+Y:gv w=$1&-h.?gYe|}[! #T-|<MGWlqKt)Wii!=AExH]eyB!P1rr 1 #$%60@"358:n| 2ERgSs{PTXkmyzzuFg'8?mDQSVWYJhwf "X&es) '245ArJ=Nd}jlr=dyu& w&T:<<<9@BP1Qg\ds{ttry{uB{`giy _ 9[Ys.l4P3VeikLw}YL^RSfzf~  $$k>lC6MT^bZtt:-X.ATrDtRv]R #C-};<JMbmYsyy*/CJ} 5#:eLa8fpa^P78=U/1W]bxZG#) .<67@AwKu,DQTW{2 (!-11b=C`lNtv|w&;v%#5*MAnG&MU eDhi;m(quz[  ('/+0006b<=fRVp]~od? aUAIJ@^z^ixs F+Lr  ?%GOfgCCH['mSV[m~"  ;;VR]US[r ~ O $4F HX_D #jDG\j]`awA O<Jl9x 1Z9ipqx @,00326=AuS6is {+O/9<SI RD\;{ E*,8TcgszQ5vk$((b+SX_g\jy4 +?Oael+o3tu0zz~"73:Ym\{}Y;<=S:*,>&IKw#Rtd05L)UX/\'545Q;DUZ\y *B[d3mw{;!H)18;sDLb2rt`z|+ -:wYxYkz6 q)*8Ofoq|kBY]^ai~{$B8]cjno|^ 47M\r~/6@e'BHBJK{L+bvj5nq"%L.0 2FNYt x;MOWY7*$>[kv5z~~9T )FnNNOFTckr sf &2DEQJNe 0t%^02K7W1#KVhXkil-(>zCtV?y{G6z.1Ne3o Jx&JKN| $>;X7 ~8HACI7ahtuR$F/&@xYFZ}!%>.4BPZ\`Wdju(z h );}TTm 3t</` w?=Fnt ",A=qCCQtEw{!} DRES1b{m}+,2Kn{d0YAdv= e *-$02RV C(9)?2G7QW|gnq$*bON`v@wt/+[noZt{@22(.))22@UnknownGz Times New Roman5Symbol3& z Arial"h&&  !242QKX)?M22 Registration and Medical Information/Release Form Paige Heath Paige HeathOh+'0  0< \ h t4 Registration and Medical Information/Release Form Paige HeathNormal Paige Heath2Microsoft Office Word@G@`@[!՜.+,0 hp|  EIS ' 3 Registration and Medical Information/Release Form Title  !"#$%&'()*+,-/012345789:;<=@Root Entry FܴBBData  1Table1WordDocument.SummaryInformation(.DocumentSummaryInformation86CompObjq  FMicrosoft Office Word Document MSWordDocWord.Document.89q