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Athlete Medical FormHealth History (pages 1 & 2 to be completed by the athlete or parent /guardian/caregiver)Health History Medical FromCountyOrganization PENTATHLETE INFORMATION First NameMiddle

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Pages 1 & 2 contain general information about the taxpayer and dependents.

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The purpose of pages 1 & 2 is to gather basic information about the taxpayer and their dependents for tax reporting purposes.

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Pages 1 & 2 require information such as name, address, Social Security Number, and relationship to the taxpayer.

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