ࡱ> 685@ bjbjצצ ";~~~8C$:,,,_} $gR-&__&&,&,&,X @O0Z~<"0CC^CC G 0w k ~t~MONTOYA SOCCER ACADEMY MEDICAL RELEASE AND WAIVER FORM Complete the form, print it, sign it, then mail it MSA. I give my son/daughter permission to participate in Montoya Soccer Academy's training sessions. I acknowledge that my son/daughter has private medical insurance and is in good physical health to participate. I hereby authorize the Montoya Soccer Academy staff to act accordingly in their best judgment in any emergency requiring medical attention and I hereby waive and release Montoya Soccer Academy from any and all liability for any injuries and illness while at the Montoya Soccer Academy training. Please type "ACCEPT" (all capital letters) indicating your agreement with the waiver.  FORMTEXT       Parent/Guardian Name:  FORMTEXT   8qrt ʷʝkL7)hq]5B*CJOJQJ\^JaJph=jhq]5B*CJOJQJU\^JaJmHnHphu8jhq]5B*CJOJQJU\^JaJph)hq]5B*CJOJQJ\^JaJph2jhq]5B*CJOJQJU\^JaJph%hq]5B*CJOJQJ\aJph%hq]5B*CJOJQJ\aJphhq]hq]56OJQJ\]^Jhq]5CJ$OJQJ\^J89qrst @BDF(Jrvx^ !$a$r  .02<>@(Bbprtպ蝛ՆkaUaKaKaCjhq]Uh OJQJ^Jhq]CJOJQJ^Jhq]OJQJ^J4jhq]5B*CJOJQJU\aJph)hq]5B*CJOJQJ\^JaJphU9jhq]5B*CJOJQJU\aJmHnHphu4jthq]5B*CJOJQJU\aJph%hq]5B*CJOJQJ\aJph.jhq]5B*CJOJQJU\aJph    Date:  FORMTEXT       ___________________________________________ Signature Please mail to: Montoya Soccer Academy Albertin Montoya 2461 Boxwood Dr. San Jose, CA 95128  2002 Montoya Soccer Academy. All rights reserved. tzhq]OJQJ^Jhq]6CJOJQJ]^Jhq]^ 1h/ =!"#$%tDText1tDText2DM/d/yyyyenter today's dateDd (#0  # AbFD/\ɱY|" nD/\ɱY|PNG  IHDRX}sRGBIDATx^]Qh#IzIdhdꀎZ` 2^f@F s;6\a w(o Y`A 0 bp6G$_fvFnUUR}J%q,߰&~bIݏT>)qi:ԷX#npmdʞpPpEsaazǵpTJ4 MQߥێo5c"yYZ/s9|*w.8),O皪hHl)ǥcw`W9v L+d詔*6CcMW},8'zam>_"a)3C1wիm* q OA )^0vI*hdRkoS k\[1aN^۳+Ֆc{ŢlVǟ1uhrW$+f%®jh}I Z/wFSv:a7ؑA2kNslQx՛x7 _ze2r%pRwl\Ra˲A (lm0#SlAղF&;g.S9nGw2] ۈEHsͤ EV3t]:\~EޔE:Bt]b[4 ͗L {(I=I7ss]sBakg|F*`2v5`ԨkPn{uI_-d&c+EJ6:֒mowv YlA)k |>cF I!2+]p3#TێEx1`bYN}e۶)raml8ޭE|4%:w`}dw1k},rrטTFfcv!#vžCV.b)f0F~Y.0`;` #TؑZ"iGu'.|- }sxۿB@@ bB-Z_uou^A|[e+w`~,jK>EOq܍IB:鈄B;&$hm\Mcmiɍ˄P FR*sCitHmHP]$vsh/{Q7@J cjx5usXVUXy8){}4Z+⬑ݔlOH XO G;oͶERZ-U雅RʹUP7_:;i D'6 L`^G\jZv1@6qi^Dąsd;Ezl k̦L>-AM5,:vXL }j;,챊SQE@~~f -`,o^q 3?_V $Bwxb@b]diʶ4X;'Vgc#*u*J\Y[Z[zἌRBJ>f[{oaxs8f`Ng(W$gWH~u\)RW+OQ4 ^Vzޒ:،S6#zN2k͎/I LQc:2bG > WG&yI+K`Atw<=Yyn,g^-v_^}2 K1bY-Y_T T _ ׄe ZL.MQcabQS@@ c 0vb=,s|J+aKؠ㩏 `@""(iL.7H#!(nBM\yX5<?M*({:E=9Db>fOpN~Z^UxG=:LLȐn huqw5 J&mRpNEѦ@@ (F}%%){΅7)wec`P=ݶɟzwI`&1Οs1A(/x䊕QX Q$L*bOQ`5PE< 3+:sV$Z s_vĈ{@ v~>&)+>[X>[bcQzRY__V*#)&6 ; %v p?#s4d&.{UH" $F)dFJ2p"ek#J N+FՏ(C߀F Y {\J≻P=[R@KEecͤL ]Z x\֗`x~ bDE hJFcȑo%5@ur`{kko0G"*F8QJfnF 6si[PL؉b5j/~{h}XģxؠG{mP>5vFOF6x3釲gtF \ K> c"wU7i/͛FWf)yIfDMg23iMF<B2nC/ k om;x^`*Mg5S{ˆw "[Oҹz+38Cyn %LxF]ߵqp?ωkeM;#wǠ8 yliBfQNԂ{/&6ٳ,6|hQ7L`j:dOF1p@!p( z[Ξdq?ϡ|67Z-<ʼNL{$VG=-(Ky_bIYY~ͿˤS3#ҍZKk<ɪoaMgj?D<d?G EG$Cä牟w-9yhAdg8{rz %RGP;33{Vp6[ }2Y&"3Հ@)Zͮtfϗ FGA z_ I Ar|uX "Ӄ>x)9'-: n#,µBS2{Y4(Wѩ@@ D2FDOku62,+paxDa"׀vʿSrxA@@ ?N IENDB`@@@ NormalCJ_HaJmH sH tH DA@D Default Paragraph FontVi@V  Table Normal :V 44 la (k@(No List 4@4 Header  !4 @4 Footer  !B^@B Normal (Web)dd[$\$89qrstl !"#OYZ[\l00000000000000000000000@0@0@0@0 _:::= t   FFF8@0(  B S  ?Text1Text2 < ! ! "  s  ! " T< ܊p " # \;# <#  p > # D# p   L" T   ,#  #  # #[[cjJJRYllt{     biqqQX``sz    >*urn:schemas-microsoft-com:office:smarttags PostalCode9*urn:schemas-microsoft-com:office:smarttagsState8*urn:schemas-microsoft-com:office:smarttagsCity:*urn:schemas-microsoft-com:office:smarttagsStreet;*urn:schemas-microsoft-com:office:smarttagsaddress=*urn:schemas-microsoft-com:office:smarttags PlaceType=*urn:schemas-microsoft-com:office:smarttags PlaceName9*urn:schemas-microsoft-com:office:smarttagsplace _c3q] @+(0@0 0UnknownGz Times New Roman5Symbol3& z Arial7&  Verdana5& zaTahoma"Xh;DkּfCk ++#24doo3H(? MONTOYA SOCCER ACADEMY TRAININGpeterhi Peter HigaOh+'0 $0 L X d p| MONTOYA SOCCER ACADEMY TRAININGONTpeterhieteete MSA_Medical Peter Higa12eMicrosoft Word 10.0@@k#t@G0@K;+՜.+,0 hp   Bullant IncO  MONTOYA SOCCER ACADEMY TRAINING Title  !"#$&'()*+,./012347Root Entry FJZ9Data P1TableCWordDocument"SummaryInformation(%DocumentSummaryInformation8-CompObjj  FMicrosoft Word Document MSWordDocWord.Document.89q