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Parent/Guardian Consent

This form is required 

for clients under the age of 18.

In order to complete this form 

you must be the Parent/Guardian of 

the Minor client named.

Minor's Full Name*

Minor's Date of Birth*

Parent/Guardian's Full Name*

Parent/Guardian's relationship to the minor*

Parent/Guardian's phone number*

Parent/Guardian's email address*

Terms of Service *

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