New England School of Archery Release Form

 

                             NEW ENGLAND SCHOOL OF ARCHERY, INC.

                                                                              109 SCHOOL ST.

                                                               CONCORDNH  03301  (603) 224-5768 

                                                                        NESAINC@AOL.COM

 

 

_____Individual Application for Archery Lessons


_____Individual Application for Archery Tournament

 

 

Date:________                                Phone/Cell:_______________________

 

Name of Student:_______________________________________________

 

Address:______________________________________________________

 

City:________________State:_________________Zip:_______

 

                                  Parent’s Consent and Release For

                  Junior Olympic Archery Development Program Participation

 

                      I,______________________________________in consideration

                                      (parent or guardian)

              of the National Archery Association, Incorporated of the United States


                         permitting:____________________________________

                     to participate in its Junior Olympic Archery Development Program


does hereby consent to such participation and in the event of  injury or accident does hereby release, 

discharge and absolve the National Archery Association, New England School of Archery, Inc. and 

KIDS  ONLY organizers and its Junior Olympic Club from any and all liability or responsibility therefore.

 

      Signed at:________________________________________

                                                       (town)

 

This day of ___________ in the month of _________ in the year_________


Signature:_________________________________________________

 

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