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Safety Instructors Insurance Program RENEWAL QUESTIONNAIRE Backyard Swim Instruction ONLY Name of Authorized Provider/ Training Partner: Street Address: City: Province: Home Phone: Business Phone:
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The name of the authorized provider is the entity or individual authorized to act on behalf of a company or organization.
The company or organization is required to file the name of the authorized provider.
The name of the authorized provider can be filled out by providing the legal name and contact information of the entity or individual.
The purpose of the name of authorized provider is to designate who has the authority to act on behalf of the company or organization.
The information reported on the name of authorized provider should include the legal name, contact information, and authorization details of the entity or individual.
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