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TEA TREE GULLY AMATEUR SWIMMING CLUB INC. “Teaching the art and encouraging the sport of swimming.” Medical Consent Form *Please use block letters when filling out this form
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Document Date: 2012-02-02 23:38:59

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File Size: 55,66 KB

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Company

TEA TREE GULLY AMATEUR SWIMMING CLUB INC. / Tree Gully Amateur Swimming Club Inc / /

Event

Music Album Release / /

Facility

Club Officials / /

MedicalCondition

e.g. epilepsy / allergies / illness / eg asthma / diabetes / seizures / ear disorder / /

MedicalTreatment

first aid / drainage / /

MusicAlbum

Signature / /

Position

medical specialist / swimmer / /

Product

Additional information eg Medication / /

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