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Registration Form

Please fill out the following form.

Date of Birth
Day
Month
Year
Blood Group
Have you been hospitalized in the last 12 months?
No
Yes
Are you suffering from a medical condition, illness or injury?
No
Yes

I, the undersigned, acknowledge that I have no physical impairments or illnesses that I know of that could endanger myself or others. I have read and understood the foregoing assumption of risk, and release of liability and I understand that by signing it obligates me to indemnify the parties named for any liability for serious or fatal injury of any person and damage to property caused by my negligent or intentional act or omission. I understand that by signing this form I am waiving valuable legal rights.

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