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20172018 LIABILITY & MEDICAL RELEASE My child (named below) is physically able and has my permission to participate in the Claude Moore Community Builders Program, to be held June 2017 through March

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What is my child named below?

Your child is named below.

Who is required to file my child named below?

The person legally responsible for the child is required to file your child's information.

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You can fill out your child's information by providing all required details accurately.

What is the purpose of my child named below?

The purpose of your child's information is for record-keeping and tax purposes.

What information must be reported on my child named below?

You must report all relevant information about your child, including their full name, date of birth, and social security number.

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