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To be filled by parents/guardians of young participants.
Participant’s Name:*
Participant's MLI ID:*
You may release my child to the following person/people:
Name:
Relationship:
Contact number:
Name:
Relationship:
Contact number:
IN CASE PARTICIPANTS ARE AUTHORIZED TO SIGN THEMSELVES OUT.
I authorize my child to sign her/himself in and out each day. I acknowledge that MLI is not responsible once the child is signed out.
Parent/Guardian’s Name:
*
Contact number:
*
Email Address: *
Comments:
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