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2008 Tryouts For Penn State College
showcase Team * * * * * * * * * * * * * * * * * * * * * * PAYMENT INFORMATION: Cash____ Check_____ CC (Visa/MC/Am Ex) $___________ Amount Pd:_________ Balance:___________ Card Number:____________________________ Exp Date:____________________ Cardholder Signature:____________________________________________ My child is in excellent physical health and is capable participating in strenuous physical activity, and waives Backcourt Hoops to act for me according to their best judgment in the case of an emergency, requiring emergency attention. I understand that I am responsible for the payment of any such medical expenses. Signature of Parent/Guardian:___________________________ Date:______________ 12/08/04 JJF
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