Permission Request Form (January 2019)
Please complete this permission request form for the Klondike Derby on January 19, 2019 at Quail Hill. After completing the form you will receive an email with a PDF with the permission slip for you to sign and return.
Participant Last Name
Participant First Name
Participant Cell Phone #
This is the mobile # of the participant, not the mother or father or brother or grandmother, etc. If no mobile #, leave blank.
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