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Medical Release Form

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Medical Release Form

If you are 18 or older, please complete this form yourself.

Parents/Guardians, please provide the following information for your minor child/student.

*Please complete new form for each participant.

Participant Info

Below is a list of over the counter medicaines. PLEASE CHECK beside each one that your student/child has permission to have in case of a headache, stomachache, or diarrhea.

First and Last Name(s), Phone Number(s), and Relationship to Student

Medical History

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