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Enrollment Form Worth County R III
Of______________________________________, a minor,
do hereby consent to said Minor participating in ______________________________________
(explain activity) conducted by: ______________________________________
Authorization of Consent to Treatment of Minor:
(I) (We), the undersigned, parent(s) of ______________________________________, a
minor, do hereby authorize ______________________________________, hereinafter "Agent",
for and on behalf of the undersigned to consent to any x-ray...
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