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PARENT/GUARDIAN #1 (if you are under 18 years old)

MEDICAL/EMERGENCY CONTACT INFORMATION
We ask that you fill-in the following information as you are comfortable, so we might assist you in the event of an emergency.

WAIVER INFORMATION
I, the undersigned, individually (or in the case of a minor, on behalf of the above-named entrant), acknowledge that the entrant will be using facilities at his/her own risk. I, on my own behalf, hereby release, discharge and indemnify the NYCTHA from all liabilities for damage, injury or illness to the entrant or his/her property during his/her participation in or travel to or from any NYCTHA event.
 

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