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Y of Montclair Panthers Travel Basketball Team Athlete s Name Age Date of Birth MONTH DAY YEAR Address ss City Zip Parent/Guardian Home phone Cell phone Email Hotmail/Gmail/Aol/etc YMCA of Montclair 25 Park Street Montclair NJ 07042 973 744-3400 www. For the consideration contained herein I hereby consent to the foregoing on behalf of my minor child. I hereby release and discharge the YMCA Of Montclair YMCA of the USA and third parties collaborating with the YMCA Of Montclair and/or YMCA of...
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