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! Mailing Address:
t
! Home Phone:
I
Team (circle one): Junior Division (Grades 2-5) Senior Division (Grades 6-8)
The purpose of the above listed information is to ensure that medical personnel have details of any medical problems, which may
impact emergency treatment.
Please note any medical issues that your child's coach may need to know for
practices and games:
I also give my permission for the Skylands Field Hockey Association to take and use any photograph or
video/audio recording in which my child appears for promotional purposes on the association website.