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I request and authorize physicians dentists and staff duly licensed as Doctors of Medicine or Doctors of Dentistry or other such licensed technicians or nurses to perform any diagnostic procedures treatment procedures operative procedures and x-ray treatment of the above minor. I agree to indemnify the Parish Youth Ministers Volunteers and the Diocese of Arlington for any costs or expenses arising out of my child s participation in the activities including the cost of any medical care given...
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01
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02
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06
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