Get the free Revised, - Ellington Senior Center, CT

To the fullest extent permitted by law I agree to indemnify and hold harmless the Town of Ellington and its employees from any injuries or damages caused by or resulting from participation in any program offered by the Ellington Senior Center. Thank you Erin R. Graziani Senior Center Director Revised 11/01/2016 NAME STREET ADDRESS TOWN STATE ZIP CODE TELEPHONE NUMBER CELL PHONE EMAIL ADDRESS DATE OF BIRTH ALLERGIES Do you have any allergies If yes please explain Specify Special Assistance you...

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