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Wellness Warriors Information session July 11, 2026. Sign-up, Waiver, and Release of Liability
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Email
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I am 18 years of age or older
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Your first name
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Your last name
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Street Address
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Your answer
City/Town
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Your answer
State
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Zip code
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Phone number (xxx-xxx-xxxx)
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What type of cancer were you diagnosed with?
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Amateur Athletic Waiver and Release of Liability: Read Before Signing
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By checking this box I am agreeing to the waiver and release of liability and this constitutes my signature
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