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RELEASE OF LIABILITY
I, {Name}, (herein "Participant"), hereby acknowledge and agree to the following, as a condition of {participation in an event or activity, membership to a club, etc.}:
I attest that I have read and understand this document, and agree to all the provisions listed above.
___________________________                      __________________________
Participant Name                                                 Participant Signature
Date:
___________________________                      __________________________
Witness Name                                                     Witness Signature
Date:
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