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Medical Release & Permission Form Page 1 of 2 January 2016 2013 January 1, to December 2015 Effective dates: January 2013 2017December 31, 2017 2016 January 2015 to December Please print in ink Name:
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Age birthday - birchman refers to the annual declaration of birthdate.
All individuals are required to file age birthday - birchman.
Age birthday - birchman can be filled out online through the designated website.
The purpose of age birthday - birchman is to update the individual's birthdate information.
The information required to be reported on age birthday - birchman includes the individual's full name and birthdate.
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