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Fill and Sign the Management Shall Incur No Financial Liability for Form

Fill and Sign the Management Shall Incur No Financial Liability for Form

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© 2017 - Cottonwood Equestrian Publications AUTHORIZATION TO OBTAIN MEDICAL TREATMENT FOR MINOR CHILD WITNESS THIS AGREEMENT AND AUTHORIZATION by and between FARM NAME, hereinafter referred to as "Management," and ________________________________, hereinafter referred to as "Parent."Management is hereby authorized to obtain any and all medical treatment Management deems reasonably necessary for my minor child and/or children.Parent or guardian agrees to bear any cost connected therewith and shall pay promptly upon billing by the health care provider. Management shall incur no financial liability for medical treatment obtained pursuant to this authorization. Name(s) of child(ren)Social Security No.Health Insurance Carrier:Plan or Identification No.Primary Healthcare Provider Signature of Parent or GuardianSTATE OF MINNESOTACOUNTY OF _________________ This instrument was acknowledged before me on _____________ day of __________________, 20________ by _________________________________. ______________________________Notary PublicPrinted Name: _________________ My Commission Expires: © 2017 - Cottonwood Equestrian Publications____________________

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The best way to complete and sign your management shall incur no financial liability for form

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How to Sign a PDF on a Mobile Device How to Sign a PDF on a Mobile Device How to Sign a PDF on a Mobile Device

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How to Sign a PDF on Android How to Sign a PDF on Android

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  • 4.Tap on Tools tab -> Signature, then draw or type your name to eSign the template. Fill out empty fields with other tools on the bottom if necessary.
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