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Submitted URL: https://e.packers.com/T/v6000001920c2fcd96b898fa6e96c566a0/15cb22c22bd949280000021ef3a0bcc3/15cb22c2-2bd9-4928-999c-4d...
Effective URL: https://waiver.smartwaiver.com/w/7ob79nynqwdxveybfzx6ht/web/?utm_source=epsilon&utm_content=240918_TTPumpkinPalooza&utm_medium=...
Submission: On September 20 via api from US — Scanned from CA
Effective URL: https://waiver.smartwaiver.com/w/7ob79nynqwdxveybfzx6ht/web/?utm_source=epsilon&utm_content=240918_TTPumpkinPalooza&utm_medium=...
Submission: On September 20 via api from US — Scanned from CA
Form analysis 1 forms found in the DOM
Name: mainform — POST
<form method="post" action="" name="mainform" id="mainform" enctype="multipart/form-data" autocomplete="off">
<div id="scroll_down_space_holder"></div>
<div class="fullscreen" id="layout">
<div class="device">
<div class="content">
<div id="company_logo_and_header_at_top_of_waiver" class="curved_corner_div">
<table id="header_with_logo_and_header_text">
<tbody>
<tr>
<td id="td_for_logo_in_header" align="center"><img src="https://dk45kac2rnn4w.cloudfront.net/66bce91bbd926.jpg" id="company_logo_for_waiver" data-widthoflogo="783" width="400"></td>
<td align="left" colspan="1" style="">
<p class="ql-data" style="text-align: center;"><strong style="font-size: 20px;">RELEASE AND WAIVER OF LIABILITY</strong></p>
<p class="ql-data" style="text-align: center;"><strong style="font-size: 20px;">TITLETOWN PUMPKIN PALOOZA CARVING</strong></p>
<p class="ql-data" style="text-align: center;"><strong style="font-size: 20px;">2024</strong></p><br><a id="reviewPrivacyPolicy" href="javascript:void(0);" class="template_tasmanian_d_button">Review Titletown's Privacy Policy</a>
</td>
</tr>
</tbody>
</table>
</div>
<div id="body_of_the_waiver" class="curved_corner_div">
<table>
<tbody>
<tr>
<td colspan="2">
<p class="ql-data" style="text-align: center;"><strong style="font-size: 22px;">-- READ BEFORE SIGNING --</strong></p>
<p class="ql-data" style="text-align: justify;">The undersigned participant, or minor participant(s), by and through his/her/their parents or guardians (collectively the “Participant”) desires to participate in pumpkin carving at
Titletown Pumpkin Palooza, currently scheduled for October 19, 2024 (the “Activity”). Participant understands and acknowledges that there are serious risks (collectively, the “Risks”) inherent in participating in the Activity,
including but not limited to the risk of: exposure to communicable diseases, viruses, bacteria, or illnesses or the causes thereof (including but not limited to COVID-19 or its variants); minor and serious bodily injury, including
severe or minor cuts, punctures, or wounds, scratches, bruises, sprains, and injury to the head, neck or spine, muscles, bones, ligaments, tendons, connective tissues, and internal and external organs; allergic or
other reaction to the pumpkin or the utensils; loss of or damage to sight, hearing, or teeth; nerve damage or compression; stroke; heart strain and problems, including heart attack; loss of or damage to equipment/property;
emotional or psychological injury; pain; scarring and disfigurement; injuries or impairment to other aspects of my body, general health, and well-being; permanent trauma; paralysis; and death, and that severe social and
economic losses might result such as long or short term disability, loss of income, career opportunities or the enjoyment of life, which may be caused by, without limitation: injuring caused by carving utensils; the condition
of the carving area; equipment failure; inadequate safety measures; participants of varying skill levels; exhaustion/overheating/dehydration due to temperature; close physical contact/crowding with other participants, spectators,
animals and insects, or other natural or manmade objects; my own actions or inactions; the actions or inactions of others participating in the Activity; the conditions in which the Activity takes place; the rules of operation;
changes in weather conditions; exceeding one’s own abilities; and/or the negligence of the “Releasees” named below. I further acknowledge that any instruction, supervision, and enforcement of rules by the “Releasees” named below
do not and cannot guarantee my safety, and may be incomplete or imperfect. I understand I am responsible for determining whether I am physically and medically able to participate in the Activity. In addition, I fully understand
that there may be other, additional risks either known or unknown to me, or not readily foreseeable at this time.</p>
<p class="ql-data" style="text-align: justify;">In exchange for the permission granted to me to participate in any way in the Activity by Titletown Development, LLC (“Titletown”), the undersigned Participant accepts and assumes
complete and absolute responsibility for all Risks encountered by Participant as a result of their purely voluntary participation in the Event. The Participant agrees to release, hold harmless and indemnify Titletown Development,
LLC, Green Bay Packers, Inc., the National Football League and its professional member clubs, Delaware North Companies, Inc., Titletown Sportservice, Inc., H.J. Martin and Son, and their respective agents, assigns, owners,
affiliates, officers, directors, and insurers (collectively, the “Releasees”) from any actions, suits, damages, claims, or judgments that may result from any personal injury, property damage, or death which the Participant may
sustain while participating in the Event, even if the injury or damage is caused by the negligent act or omission of the Releasees or its agent. This release of liability shall be a full and final compromise and settlement of any
claims for any injury or damage suffered by the Participant as a result of the Activity. Nothing in this Release shall be construed as a release, discharge, or waiver any claim that Participant may have for reckless or intentional
acts of the Releasees or their respective agents.</p>
<p class="ql-data" style="text-align: justify;">In addition, the Participant further agrees to indemnify the Releasees, and their respective agents, assigns, owners, corporate subsidiaries, affiliates and parents, officers,
directors, and insurers, from any and all actions, suits, damages, claims, or judgments that may result from any personal injury or property damage which any other persons may sustain as a result of the Participant’s conduct
during or relating to the Activity.</p>
<p class="ql-data" style="text-align: justify;">Participant agrees that if any portion of this Agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect. If there are any disputes
regarding this Agreement, Participant hereby waives any right I or anyone on my behalf may have to a trial and agree that such dispute shall be determined by binding arbitration before three neutral American Arbitration
Association arbitrators in Green Bay, Wisconsin. Each Party shall be responsible for their own costs and expenses issued in connection with the arbitration, suit or action, including attorney's fees and costs at the arbitration,
suit or action and to enforce any arbitration award in court and on appeal. TITLETOWN AND PARTICIPANT AGREE THAT ALL DISPUTES SHALL BE ARBITRATED ON AN INDIVIDUAL BASIS AND WAIVE ANY RIGHT TO LITIGATE OR ARBITRATE ANY CLAIM AS A
CLASS ACTION, REPRESENTATIVE ACTION, OR CLASS ARBITRATION. IF PARTICIPANT DOES NOT CONSENT TO THIS CLAUSE, HOLDER MUST NOT PARTICIPATE IN THE ACTIVITIES. THIS CLAUSE IS GOVERNED BY THE FEDERAL ARBITRATION ACT.</p>
<p class="ql-data" style="text-align: justify;">Participant authorizes the Releasees, and anyone authorized by them, to retouch or alter their carved pumpkin, or any photographs, video, or other media taken of the event Participant
and use them, in whole or in part, with or without the Participant’s name, signature, and/or biographical information or other identification of any other fictitious or real person, in any and all media, for advertising or
commercial purpose, and to claim and register its copyright in same; and further, release and hold harmless the Releasees and their respective employees, directors, officers, agents, successors, and assigns from any and all
liability arising from the use of the Participant’s pumpkin and/or the Participant’s photograph and from any blurring, distortion or optical illusion which may occur or be produced, as well as from the use of the Participant’s
name, signature, and/or biographical information; and further relinquish all right, title and interest in and to the pumpkin and any photograph or media of Participant, the negatives and prints and their reproduction, including
the right to approve their final form, context and use.</p>
<p class="ql-data" style="text-align: justify;">Statement of Understanding: The undersigned has read and understands this document, and enters into it on behalf of the Participant and Participant’s family, spouse, heirs, executors
and assigns, and anyone acting on Participant’s behalf, including attorneys, agents, insurers and representatives. The undersigned also acknowledges that the undersigned has had sufficient time to read this document, has had the
opportunity to consider the consequences of signing this Agreement, and has had an adequate opportunity to ask questions regarding this Agreement.</p>
<p class="ql-data" style="text-align: justify;"><strong>I HAVE CONSIDERED THAT IF THIS WAIVER OF LIABILITY WERE NOT AS BROAD AS IT IS, THE COST FOR MY PARTICIPATION IN THE ACTIVITY WOULD BE CONSIDERABLE, AND AS I DO NOT WISH TO PAY
A CONSIDERABLY HIGH COST, I WAIVE THE RIGHT TO BARGAIN FOR DIFFERENT WAIVER OF LIABILITY TERMS.</strong></p>
<p class="ql-data"><br></p>
</td>
</tr>
</tbody>
</table>
</div>
<div data-age-min="0" data-age-max="0" id="whoisdiv" class="section curved_corner_div">
<div id="who_force_static_height"><input type="hidden" id="howmany_additionalpartminors" data-howmany_additionalpartminors="yes" name="howmany_additionalpartminors" value="0"><input type="hidden"
id="parentisparticipantanddoesntneedseperate" name="parentisparticipantanddoesntneedseperate" data-humantitle="Include yourself as an additional Participant" value="No"><input type="hidden" id="minor_signatures_are_required"
data-minorsignature_required="no" name="minor_signatures_are_required" value="no">
<center>
<div id="who_please_select_who">Please select who will be participating...</div>
<a href="javascript:void(0);" class="template_tasmanian_d_button" id="who_you" data-whobutton="yes" data-isadultbutton="yes">Adult</a><a href="javascript:void(0);" id="who_oneormoreminors" class="template_tasmanian_d_button">Minor(s)</a><a href="javascript:void(0);" id="who_oneormoreminorsandyou" class="template_tasmanian_d_button" data-whobutton="yes">Adult and Minor(s)</a><br><a href="javascript:void(0);" data-whobutton="yes" data-isaminorbutton="yes" data-minorbutton="1" onclick="howmany_minors_press(1);" class="template_tasmanian_d_button" style="display: none;">1 Minor</a><a href="javascript:void(0);" data-whobutton="yes" data-isaminorbutton="yes" data-minorbutton="2" onclick="howmany_minors_press(2);" class="template_tasmanian_d_button" style="display: none;">2 Minors</a><a href="javascript:void(0);" data-whobutton="yes" data-isaminorbutton="yes" data-minorbutton="3" onclick="howmany_minors_press(3);" class="template_tasmanian_d_button" style="display: none;">3 Minors</a><a href="javascript:void(0);" data-whobutton="yes" data-isaminorbutton="yes" data-minorbutton="4" onclick="howmany_minors_press(4);" class="template_tasmanian_d_button" style="display: none;">4 Minors</a><a href="javascript:void(0);" data-whobutton="yes" data-isaminorbutton="yes" data-minorbutton="5" onclick="howmany_minors_press(5);" class="template_tasmanian_d_button" style="display: none;">5 Minors</a><a id="moreminors_button_whoparticipating" href="javascript:void(0);" data-whobutton="yes" data-minorbutton="-1" onclick="howmany_minors_showmore();" class="template_tasmanian_d_button" style="display: none;">More Minors</a><a href="javascript:void(0);" data-whobutton="yes" data-isaminorbutton="yes" data-minorbutton="6" data-onlywhenmoreminors="yes" onclick="howmany_minors_press(6);" class="template_tasmanian_d_button" style="display: none;">6 Minors</a><a href="javascript:void(0);" data-whobutton="yes" data-isaminorbutton="yes" data-minorbutton="7" data-onlywhenmoreminors="yes" onclick="howmany_minors_press(7);" class="template_tasmanian_d_button" style="display: none;">7 Minors</a><a href="javascript:void(0);" data-whobutton="yes" data-isaminorbutton="yes" data-minorbutton="8" data-onlywhenmoreminors="yes" onclick="howmany_minors_press(8);" class="template_tasmanian_d_button" style="display: none;">8 Minors</a><a href="javascript:void(0);" data-whobutton="yes" data-isaminorbutton="yes" data-minorbutton="9" data-onlywhenmoreminors="yes" onclick="howmany_minors_press(9);" class="template_tasmanian_d_button" style="display: none;">9 Minors</a><a href="javascript:void(0);" data-whobutton="yes" data-isaminorbutton="yes" data-minorbutton="10" data-onlywhenmoreminors="yes" onclick="howmany_minors_press(10);" class="template_tasmanian_d_button" style="display: none;">10 Minors</a>
<div id="who_english_description"></div><a href="javascript:void(0);" data-whobutton="yes" id="who_begin" class="template_tasmanian_d_button template_tasmanian_d_button_large" style="display: none;">Continue</a>
</center>
</div>
</div>
<div id="hide_until_start_button_pressed" style="display: none;">
<div class="section curved_corner_div" data-age-min="0" data-age-max="0">
<div class="dob_default_location dob_default_location_participant"></div>
<table cellpadding="10" border="0" width="100%">
<tbody>
<tr valign="top">
<td>
<div class="section_body">
<div class="section_title"><span class="participant_namefor_possessive_first">First </span><span class="participant_namefor_possessive">Participant's</span> Name</div>
<div class="offset_under_section_title">
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="12" type="text" data-isnamefirst="yes" data-checkcapitalization="yes" placeholder="First Name"
data-humantitle="First Name" autocomplete="one-time-code" data-titleforvalidation="First Participant" name="participant_firstname" id="participant_firstname" value=""><br><span class="swform_title">First Name<span
class="swform_reqasterisks">*</span></span></div>
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="27" type="text" data-isnamelast="yes" data-checkcapitalization="yes" placeholder="Last Name"
data-humantitle="Last Name" autocomplete="one-time-code" name="participant_lastname" id="participant_lastname" value=""><br><span class="swform_title">Last Name<span class="swform_reqasterisks">*</span></span></div>
</div>
</div>
</td>
</tr>
<tr id="table_row_participant_dob">
<td>
<div class="section_body">
<div id="participant_dob_title" class="section_title"><span class="participant_namefor_possessive_first">First </span><span class="participant_namefor_possessive">Participant's</span> Date of Birth<span
class="swform_reqasterisks">*</span></div>
<div class="offset_under_section_title">
<div style="margin: 0; padding: 0;" id="dob_all_wrapper_participant" class="dob_all_wrapper">
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-isbday="yes" data-datepart="month" data-isrequired="yes" data-isfield="yes" id="participant_month" data-dateset="participant"
name="participant_month" data-humantitle="<span class="participant_namefor_possessive_first">First </span><span class="participant_namefor_possessive">Participant's</span> - Month">
<option value="">- Month -</option>
<option value="1">1 - January</option>
<option value="2">2 - February</option>
<option value="3">3 - March</option>
<option value="4">4 - April</option>
<option value="5">5 - May</option>
<option value="6">6 - June</option>
<option value="7">7 - July</option>
<option value="8">8 - August</option>
<option value="9">9 - September</option>
<option value="10">10 - October</option>
<option value="11">11 - November</option>
<option value="12">12 - December</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-isbday="yes" data-datepart="day" data-isrequired="yes" data-isfield="yes" id="participant_day" data-dateset="participant"
name="participant_day" data-humantitle="<span class="participant_namefor_possessive_first">First </span><span class="participant_namefor_possessive">Participant's</span> - Day">
<option value="">- Day -</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-isbday="yes" data-datepart="year" data-isrequired="yes" data-isfield="yes" id="participant_year" data-dateset="participant"
name="participant_year"
data-humantitle="<span class="participant_namefor_possessive_first">First </span><span class="participant_namefor_possessive">Participant's</span> - Year"><!-- THERE IS A DUMB BUG IF THIS VALUE ISNT AFTER 2008 PREFILL DOESNT WORK -->
<option value="">- Year -</option>
<option value="2024">2024</option>
<option value="2023">2023</option>
<option value="2022">2022</option>
<option value="2021">2021</option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1923">1923</option>
<option value="1922">1922</option>
<option value="1921">1921</option>
<option value="1920">1920</option>
<option value="1919">1919</option>
<option value="1918">1918</option>
<option value="1917">1917</option>
<option value="1916">1916</option>
<option value="1915">1915</option>
</select></div>
</div>
</div>
</div>
</td>
</tr>
<tr>
<td id="ctlSignatureA_Participant_container">
<div id="ctlSignatureA_Container_title" class="section_title"><span class="participant_namefor_possessive_first">First </span><span class="participant_namefor_possessive">Participant's</span> Signature<span
class="swform_reqasterisks">*</span></div>
<div id="ctlSignatureA_Container_TypeOrDraw">
<div id="ctlSignatureA_Header" class="sig_header">
<div class="sig_header_choice fl"><input id="ctlSignatureA_RadioType" name="ctlSignatureA_Radio" type="radio"><label for="ctlSignatureA_RadioType" class="sig_header_choice_label"> Type Signature</label></div>
<div class="sig_header_choice fr"><input id="ctlSignatureA_RadioDraw" name="ctlSignatureA_Radio" type="radio" checked="checked"><label for="ctlSignatureA_RadioDraw" class="sig_header_choice_label"> Draw
Signature</label></div>
</div>
<div id="ctlSignatureA_Body" style="display:none;position: relative;">
<div id="ctlSignatureA_Type">
<div class="sig_type_table">
<div class="div_tr">
<div class="div_tc" style="height: 35%;"><input type="text" size="30" maxlength="64" placeholder="Type your name to sign..." id="ctlSignatureA_TypeSign" name="ctlSignatureA_TypeSign" class="sig_type_sign_input"></div>
</div>
<div class="div_tr" style="width: 100%;margin-bottom: 70px;">
<div class="div_tc">
<div id="ctlSignatureA_TypePreviewParent" class="sig_type_sign_preview_parent">
<div id="ctlSignatureA_TypePreview" class="sig-preview font-dancing" style="display: inline"></div>
</div><br><a href="javascript:changeSigFont('ctlSignatureA');" id="ctlSignatureA_TypeFontChanger" class="change_sig_font" style="display: none;">Change Font</a>
</div>
</div>
<div class="div_tr">
<div class="div_tc" style="vertical-align:bottom;height: 25%;">
<div id="ctlSignatureA_TypeButtons" style="display:none;float:right;">
<a href="javascript:signatureTypedAccept('ctlSignatureA');" id="ctlSignatureA_TypeAccept" class="template_tasmanian_d_button template_tasmanian_d_button_dark">Accept Signature</a><a href="javascript:signatureTypedReset('ctlSignatureA');" id="ctlSignatureA_TypeReset" class="template_tasmanian_d_button">Clear</a>
</div>
</div>
</div>
<div style="display: flex;justify-content: center;"><a href="javascript:signatureHide('ctlSignatureA');" id="ctlSignatureA_closebutton" class="template_tasmanian_d_button template_tasmanian_d_button_dark">Close</a></div>
</div>
</div>
<div id="ctlSignatureA_Draw">
<div id="ctlSignatureA_Container" class="signature_outer_box_div" data-signatureid="ctlSignatureA" data-issignaturepad="yes" data-isparticipant="yes" style="cursor: default; display: none;"><canvas id="ctlSignatureA"
width="997" height="499" class="signaturepad"
style="background-repeat: no-repeat; border-width: 0px; border-style: dashed; border-color: rgb(255, 255, 255); background-color: rgb(255, 255, 255); z-index: 99; background-image: url("/templates/assets/images/sw_underline_signature_200.jpg"); width: 997px; height: 499px;"></canvas>
</div>
<div id="ctlSignatureA_toolbar" style="margin: 5px; position: relative; height: 20px; width: 997px; background-color: transparent; display: none;"><img id="ctlSignatureA_resetbutton" src="assets/sw_refresh_icon.jpg"
style="cursor: pointer; float: right; height: 24px; width: 24px; border: 0px solid transparent; display: none;" alt="Clear Signature">
<div id="ctlSignatureA_status" style="color: rgb(0, 0, 0); height: 20px; width: auto; padding: 2px; font-family: verdana; font-size: 12px; float: left; margin-right: 30px; display: none;">Please sign</div><input
type="hidden" id="ctlSignatureA_data" name="ctlSignatureA_data" value=""><input type="hidden" id="ctlSignatureA_data_smooth" name="ctlSignatureA_data_smooth" value=""><input type="hidden" id="ctlSignatureA_data_canvas"
name="ctlSignatureA_data_canvas" value="">
</div>
<div class="offset_under_section_title_without_new_title" id="ctlSignatureA_Container_clicktosign" data-idfortip="ctlSignatureA"><br>
<div class="div_with_below_signature_options">
<div class="div_tr">
<div class="div_for_accepttip" style="padding-left: 10px;display:table-cell;vertical-align: middle;"><span class="signature_tip" id="ctlSignatureA_accepttip"></span></div>
<div class="fr" style="display:table-cell;vertical-align: middle;white-space: nowrap;">
<a href="javascript:signatureDrawnAccept('ctlSignatureA');" id="ctlSignatureA_acceptbutton" class="template_tasmanian_d_button template_tasmanian_d_button_dark">Accept Signature</a><a href="javascript:signaturepadreset('ctlSignatureA');" id="ctlSignatureA_resetbutton_custom" class="template_tasmanian_d_button">Clear</a>
</div>
</div>
</div>
<div style="display: flex;justify-content: center;"><a href="javascript:signatureHide('ctlSignatureA');" id="ctlSignatureA_closebutton" class="template_tasmanian_d_button template_tasmanian_d_button_dark">Close</a></div>
</div><input type="hidden" id="ctlSignatureA_ClickToSign_valid" value="0"><input type="hidden" id="ctlSignatureA_Container_active" name="ctlSignatureA_Container_active" value="1"><input type="hidden"
id="ctlSignatureA_SignatureType" value="type">
</div>
</div>
<div class="offset_under_section_title_without_new_title"><br>
<div id="ctlSignatureA_ClickToSign" data-isclicktosign="yes" data-idfortip="ctlSignatureA">
<a href="javascript:signatureShow('ctlSignatureA')" id="ctlSignatureA_ClickToSign_buttonnew" class="template_tasmanian_d_button">Click to Sign</a></div>
<div id="ctlSignatureA_ClickToEdit" style="display: none;">
<a href="javascript:signatureEdit('ctlSignatureA');" class="signature_image_link"><span class="signature_tip" data-signature_tip_id="ctlSignatureA" id="ctlSignatureA_SigImage"><img id="ctlSignatureA_sigpic" style="width: 16px; height: 16px;" src="/templates/assets/images/ajax-loader-b.gif" border="0" class="edit_signature_button"></span></a><br><a href="javascript:signatureEdit('ctlSignatureA');" id="signature_edit_button_ctlSignatureA" class="template_tasmanian_d_button">Edit Signature</a>
</div>
</div>
</div>
</td>
</tr>
</tbody>
</table>
</div>
<div class="section_minor curved_corner_div" data-additionalminor-pos="1" style="display: none; visibility: hidden;">
<div class="dob_default_location dob_default_location_participantadd1"></div>
<table cellpadding="10" border="0" width="100%">
<tbody>
<tr valign="top">
<td>
<div class="section_body">
<div class="section_title">Second <span class="participant_namefor_possessive">Participant's</span> Name</div>
<div class="offset_under_section_title">
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="12" type="text" data-isnamefirst="yes" data-checkcapitalization="yes" placeholder="First Name"
data-humantitle="First Name" autocomplete="one-time-code" data-titleforvalidation="Second Participant" name="participantadd1_firstname" id="participantadd1_firstname" value=""><br><span class="swform_title">First Name<span
class="swform_reqasterisks">*</span></span></div>
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="27" type="text" data-isnamelast="yes" data-checkcapitalization="yes" placeholder="Last Name"
data-humantitle="Last Name" autocomplete="one-time-code" name="participantadd1_lastname" id="participantadd1_lastname" value=""><br><span class="swform_title">Last Name<span class="swform_reqasterisks">*</span></span>
</div>
</div>
</div>
</td>
</tr>
<tr id="table_row_participantadd1_dob">
<td>
<div class="section_body">
<div id="participantadd1_dob_title" class="section_title">Second <span class="participant_namefor_possessive">Participant's</span> Date of Birth<span class="swform_reqasterisks">*</span></div>
<div class="offset_under_section_title">
<div style="margin: 0; padding: 0;" id="dob_all_wrapper_participantadd1" class="dob_all_wrapper">
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="month" data-isrequired="yes" data-isfield="yes" id="participantadd1_month" data-dateset="participantadd1"
name="participantadd1_month" data-humantitle="Second <span class="participant_namefor_possessive">Participant's</span> - Month">
<option value="">- Month -</option>
<option value="1">1 - January</option>
<option value="2">2 - February</option>
<option value="3">3 - March</option>
<option value="4">4 - April</option>
<option value="5">5 - May</option>
<option value="6">6 - June</option>
<option value="7">7 - July</option>
<option value="8">8 - August</option>
<option value="9">9 - September</option>
<option value="10">10 - October</option>
<option value="11">11 - November</option>
<option value="12">12 - December</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="day" data-isrequired="yes" data-isfield="yes" id="participantadd1_day" data-dateset="participantadd1"
name="participantadd1_day" data-humantitle="Second <span class="participant_namefor_possessive">Participant's</span> - Day">
<option value="">- Day -</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="year" data-isrequired="yes" data-isfield="yes" id="participantadd1_year" data-dateset="participantadd1"
name="participantadd1_year" data-humantitle="Second <span class="participant_namefor_possessive">Participant's</span> - Year"><!-- THERE IS A DUMB BUG IF THIS VALUE ISNT AFTER 2008 PREFILL DOESNT WORK -->
<option value="">- Year -</option>
<option value="2024">2024</option>
<option value="2023">2023</option>
<option value="2022">2022</option>
<option value="2021">2021</option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1923">1923</option>
<option value="1922">1922</option>
<option value="1921">1921</option>
<option value="1920">1920</option>
<option value="1919">1919</option>
<option value="1918">1918</option>
<option value="1917">1917</option>
<option value="1916">1916</option>
<option value="1915">1915</option>
</select></div>
</div>
</div>
</div>
</td>
</tr>
</tbody>
</table>
</div>
<div class="section_minor curved_corner_div" data-additionalminor-pos="2" style="display: none; visibility: hidden;">
<div class="dob_default_location dob_default_location_participantadd2"></div>
<table cellpadding="10" border="0" width="100%">
<tbody>
<tr valign="top">
<td>
<div class="section_body">
<div class="section_title">Third <span class="participant_namefor_possessive">Participant's</span> Name</div>
<div class="offset_under_section_title">
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="12" type="text" data-isnamefirst="yes" data-checkcapitalization="yes" placeholder="First Name"
data-humantitle="First Name" autocomplete="one-time-code" data-titleforvalidation="Third Participant" name="participantadd2_firstname" id="participantadd2_firstname" value=""><br><span class="swform_title">First Name<span
class="swform_reqasterisks">*</span></span></div>
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="27" type="text" data-isnamelast="yes" data-checkcapitalization="yes" placeholder="Last Name"
data-humantitle="Last Name" autocomplete="one-time-code" name="participantadd2_lastname" id="participantadd2_lastname" value=""><br><span class="swform_title">Last Name<span class="swform_reqasterisks">*</span></span>
</div>
</div>
</div>
</td>
</tr>
<tr id="table_row_participantadd2_dob">
<td>
<div class="section_body">
<div id="participantadd2_dob_title" class="section_title">Third <span class="participant_namefor_possessive">Participant's</span> Date of Birth<span class="swform_reqasterisks">*</span></div>
<div class="offset_under_section_title">
<div style="margin: 0; padding: 0;" id="dob_all_wrapper_participantadd2" class="dob_all_wrapper">
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="month" data-isrequired="yes" data-isfield="yes" id="participantadd2_month" data-dateset="participantadd2"
name="participantadd2_month" data-humantitle="Third <span class="participant_namefor_possessive">Participant's</span> - Month">
<option value="">- Month -</option>
<option value="1">1 - January</option>
<option value="2">2 - February</option>
<option value="3">3 - March</option>
<option value="4">4 - April</option>
<option value="5">5 - May</option>
<option value="6">6 - June</option>
<option value="7">7 - July</option>
<option value="8">8 - August</option>
<option value="9">9 - September</option>
<option value="10">10 - October</option>
<option value="11">11 - November</option>
<option value="12">12 - December</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="day" data-isrequired="yes" data-isfield="yes" id="participantadd2_day" data-dateset="participantadd2"
name="participantadd2_day" data-humantitle="Third <span class="participant_namefor_possessive">Participant's</span> - Day">
<option value="">- Day -</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="year" data-isrequired="yes" data-isfield="yes" id="participantadd2_year" data-dateset="participantadd2"
name="participantadd2_year" data-humantitle="Third <span class="participant_namefor_possessive">Participant's</span> - Year"><!-- THERE IS A DUMB BUG IF THIS VALUE ISNT AFTER 2008 PREFILL DOESNT WORK -->
<option value="">- Year -</option>
<option value="2024">2024</option>
<option value="2023">2023</option>
<option value="2022">2022</option>
<option value="2021">2021</option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1923">1923</option>
<option value="1922">1922</option>
<option value="1921">1921</option>
<option value="1920">1920</option>
<option value="1919">1919</option>
<option value="1918">1918</option>
<option value="1917">1917</option>
<option value="1916">1916</option>
<option value="1915">1915</option>
</select></div>
</div>
</div>
</div>
</td>
</tr>
</tbody>
</table>
</div>
<div class="section_minor curved_corner_div" data-additionalminor-pos="3" style="display: none; visibility: hidden;">
<div class="dob_default_location dob_default_location_participantadd3"></div>
<table cellpadding="10" border="0" width="100%">
<tbody>
<tr valign="top">
<td>
<div class="section_body">
<div class="section_title">Fourth <span class="participant_namefor_possessive">Participant's</span> Name</div>
<div class="offset_under_section_title">
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="12" type="text" data-isnamefirst="yes" data-checkcapitalization="yes" placeholder="First Name"
data-humantitle="First Name" autocomplete="one-time-code" data-titleforvalidation="Fourth Participant" name="participantadd3_firstname" id="participantadd3_firstname" value=""><br><span class="swform_title">First Name<span
class="swform_reqasterisks">*</span></span></div>
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="27" type="text" data-isnamelast="yes" data-checkcapitalization="yes" placeholder="Last Name"
data-humantitle="Last Name" autocomplete="one-time-code" name="participantadd3_lastname" id="participantadd3_lastname" value=""><br><span class="swform_title">Last Name<span class="swform_reqasterisks">*</span></span>
</div>
</div>
</div>
</td>
</tr>
<tr id="table_row_participantadd3_dob">
<td>
<div class="section_body">
<div id="participantadd3_dob_title" class="section_title">Fourth <span class="participant_namefor_possessive">Participant's</span> Date of Birth<span class="swform_reqasterisks">*</span></div>
<div class="offset_under_section_title">
<div style="margin: 0; padding: 0;" id="dob_all_wrapper_participantadd3" class="dob_all_wrapper">
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="month" data-isrequired="yes" data-isfield="yes" id="participantadd3_month" data-dateset="participantadd3"
name="participantadd3_month" data-humantitle="Fourth <span class="participant_namefor_possessive">Participant's</span> - Month">
<option value="">- Month -</option>
<option value="1">1 - January</option>
<option value="2">2 - February</option>
<option value="3">3 - March</option>
<option value="4">4 - April</option>
<option value="5">5 - May</option>
<option value="6">6 - June</option>
<option value="7">7 - July</option>
<option value="8">8 - August</option>
<option value="9">9 - September</option>
<option value="10">10 - October</option>
<option value="11">11 - November</option>
<option value="12">12 - December</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="day" data-isrequired="yes" data-isfield="yes" id="participantadd3_day" data-dateset="participantadd3"
name="participantadd3_day" data-humantitle="Fourth <span class="participant_namefor_possessive">Participant's</span> - Day">
<option value="">- Day -</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="year" data-isrequired="yes" data-isfield="yes" id="participantadd3_year" data-dateset="participantadd3"
name="participantadd3_year" data-humantitle="Fourth <span class="participant_namefor_possessive">Participant's</span> - Year"><!-- THERE IS A DUMB BUG IF THIS VALUE ISNT AFTER 2008 PREFILL DOESNT WORK -->
<option value="">- Year -</option>
<option value="2024">2024</option>
<option value="2023">2023</option>
<option value="2022">2022</option>
<option value="2021">2021</option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1923">1923</option>
<option value="1922">1922</option>
<option value="1921">1921</option>
<option value="1920">1920</option>
<option value="1919">1919</option>
<option value="1918">1918</option>
<option value="1917">1917</option>
<option value="1916">1916</option>
<option value="1915">1915</option>
</select></div>
</div>
</div>
</div>
</td>
</tr>
</tbody>
</table>
</div>
<div class="section_minor curved_corner_div" data-additionalminor-pos="4" style="display: none; visibility: hidden;">
<div class="dob_default_location dob_default_location_participantadd4"></div>
<table cellpadding="10" border="0" width="100%">
<tbody>
<tr valign="top">
<td>
<div class="section_body">
<div class="section_title">Fifth <span class="participant_namefor_possessive">Participant's</span> Name</div>
<div class="offset_under_section_title">
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="12" type="text" data-isnamefirst="yes" data-checkcapitalization="yes" placeholder="First Name"
data-humantitle="First Name" autocomplete="one-time-code" data-titleforvalidation="Fifth Participant" name="participantadd4_firstname" id="participantadd4_firstname" value=""><br><span class="swform_title">First Name<span
class="swform_reqasterisks">*</span></span></div>
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="27" type="text" data-isnamelast="yes" data-checkcapitalization="yes" placeholder="Last Name"
data-humantitle="Last Name" autocomplete="one-time-code" name="participantadd4_lastname" id="participantadd4_lastname" value=""><br><span class="swform_title">Last Name<span class="swform_reqasterisks">*</span></span>
</div>
</div>
</div>
</td>
</tr>
<tr id="table_row_participantadd4_dob">
<td>
<div class="section_body">
<div id="participantadd4_dob_title" class="section_title">Fifth <span class="participant_namefor_possessive">Participant's</span> Date of Birth<span class="swform_reqasterisks">*</span></div>
<div class="offset_under_section_title">
<div style="margin: 0; padding: 0;" id="dob_all_wrapper_participantadd4" class="dob_all_wrapper">
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="month" data-isrequired="yes" data-isfield="yes" id="participantadd4_month" data-dateset="participantadd4"
name="participantadd4_month" data-humantitle="Fifth <span class="participant_namefor_possessive">Participant's</span> - Month">
<option value="">- Month -</option>
<option value="1">1 - January</option>
<option value="2">2 - February</option>
<option value="3">3 - March</option>
<option value="4">4 - April</option>
<option value="5">5 - May</option>
<option value="6">6 - June</option>
<option value="7">7 - July</option>
<option value="8">8 - August</option>
<option value="9">9 - September</option>
<option value="10">10 - October</option>
<option value="11">11 - November</option>
<option value="12">12 - December</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="day" data-isrequired="yes" data-isfield="yes" id="participantadd4_day" data-dateset="participantadd4"
name="participantadd4_day" data-humantitle="Fifth <span class="participant_namefor_possessive">Participant's</span> - Day">
<option value="">- Day -</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="year" data-isrequired="yes" data-isfield="yes" id="participantadd4_year" data-dateset="participantadd4"
name="participantadd4_year" data-humantitle="Fifth <span class="participant_namefor_possessive">Participant's</span> - Year"><!-- THERE IS A DUMB BUG IF THIS VALUE ISNT AFTER 2008 PREFILL DOESNT WORK -->
<option value="">- Year -</option>
<option value="2024">2024</option>
<option value="2023">2023</option>
<option value="2022">2022</option>
<option value="2021">2021</option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1923">1923</option>
<option value="1922">1922</option>
<option value="1921">1921</option>
<option value="1920">1920</option>
<option value="1919">1919</option>
<option value="1918">1918</option>
<option value="1917">1917</option>
<option value="1916">1916</option>
<option value="1915">1915</option>
</select></div>
</div>
</div>
</div>
</td>
</tr>
</tbody>
</table>
</div>
<div class="section_minor curved_corner_div" data-additionalminor-pos="5" style="display: none; visibility: hidden;">
<div class="dob_default_location dob_default_location_participantadd5"></div>
<table cellpadding="10" border="0" width="100%">
<tbody>
<tr valign="top">
<td>
<div class="section_body">
<div class="section_title">Sixth <span class="participant_namefor_possessive">Participant's</span> Name</div>
<div class="offset_under_section_title">
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="12" type="text" data-isnamefirst="yes" data-checkcapitalization="yes" placeholder="First Name"
data-humantitle="First Name" autocomplete="one-time-code" data-titleforvalidation="Sixth Participant" name="participantadd5_firstname" id="participantadd5_firstname" value=""><br><span class="swform_title">First Name<span
class="swform_reqasterisks">*</span></span></div>
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="27" type="text" data-isnamelast="yes" data-checkcapitalization="yes" placeholder="Last Name"
data-humantitle="Last Name" autocomplete="one-time-code" name="participantadd5_lastname" id="participantadd5_lastname" value=""><br><span class="swform_title">Last Name<span class="swform_reqasterisks">*</span></span>
</div>
</div>
</div>
</td>
</tr>
<tr id="table_row_participantadd5_dob">
<td>
<div class="section_body">
<div id="participantadd5_dob_title" class="section_title">Sixth <span class="participant_namefor_possessive">Participant's</span> Date of Birth<span class="swform_reqasterisks">*</span></div>
<div class="offset_under_section_title">
<div style="margin: 0; padding: 0;" id="dob_all_wrapper_participantadd5" class="dob_all_wrapper">
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="month" data-isrequired="yes" data-isfield="yes" id="participantadd5_month" data-dateset="participantadd5"
name="participantadd5_month" data-humantitle="Sixth <span class="participant_namefor_possessive">Participant's</span> - Month">
<option value="">- Month -</option>
<option value="1">1 - January</option>
<option value="2">2 - February</option>
<option value="3">3 - March</option>
<option value="4">4 - April</option>
<option value="5">5 - May</option>
<option value="6">6 - June</option>
<option value="7">7 - July</option>
<option value="8">8 - August</option>
<option value="9">9 - September</option>
<option value="10">10 - October</option>
<option value="11">11 - November</option>
<option value="12">12 - December</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="day" data-isrequired="yes" data-isfield="yes" id="participantadd5_day" data-dateset="participantadd5"
name="participantadd5_day" data-humantitle="Sixth <span class="participant_namefor_possessive">Participant's</span> - Day">
<option value="">- Day -</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="year" data-isrequired="yes" data-isfield="yes" id="participantadd5_year" data-dateset="participantadd5"
name="participantadd5_year" data-humantitle="Sixth <span class="participant_namefor_possessive">Participant's</span> - Year"><!-- THERE IS A DUMB BUG IF THIS VALUE ISNT AFTER 2008 PREFILL DOESNT WORK -->
<option value="">- Year -</option>
<option value="2024">2024</option>
<option value="2023">2023</option>
<option value="2022">2022</option>
<option value="2021">2021</option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1923">1923</option>
<option value="1922">1922</option>
<option value="1921">1921</option>
<option value="1920">1920</option>
<option value="1919">1919</option>
<option value="1918">1918</option>
<option value="1917">1917</option>
<option value="1916">1916</option>
<option value="1915">1915</option>
</select></div>
</div>
</div>
</div>
</td>
</tr>
</tbody>
</table>
</div>
<div class="section_minor curved_corner_div" data-additionalminor-pos="6" style="display: none; visibility: hidden;">
<div class="dob_default_location dob_default_location_participantadd6"></div>
<table cellpadding="10" border="0" width="100%">
<tbody>
<tr valign="top">
<td>
<div class="section_body">
<div class="section_title">Seventh <span class="participant_namefor_possessive">Participant's</span> Name</div>
<div class="offset_under_section_title">
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="12" type="text" data-isnamefirst="yes" data-checkcapitalization="yes" placeholder="First Name"
data-humantitle="First Name" autocomplete="one-time-code" data-titleforvalidation="Seventh Participant" name="participantadd6_firstname" id="participantadd6_firstname" value=""><br><span class="swform_title">First
Name<span class="swform_reqasterisks">*</span></span></div>
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="27" type="text" data-isnamelast="yes" data-checkcapitalization="yes" placeholder="Last Name"
data-humantitle="Last Name" autocomplete="one-time-code" name="participantadd6_lastname" id="participantadd6_lastname" value=""><br><span class="swform_title">Last Name<span class="swform_reqasterisks">*</span></span>
</div>
</div>
</div>
</td>
</tr>
<tr id="table_row_participantadd6_dob">
<td>
<div class="section_body">
<div id="participantadd6_dob_title" class="section_title">Seventh <span class="participant_namefor_possessive">Participant's</span> Date of Birth<span class="swform_reqasterisks">*</span></div>
<div class="offset_under_section_title">
<div style="margin: 0; padding: 0;" id="dob_all_wrapper_participantadd6" class="dob_all_wrapper">
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="month" data-isrequired="yes" data-isfield="yes" id="participantadd6_month" data-dateset="participantadd6"
name="participantadd6_month" data-humantitle="Seventh <span class="participant_namefor_possessive">Participant's</span> - Month">
<option value="">- Month -</option>
<option value="1">1 - January</option>
<option value="2">2 - February</option>
<option value="3">3 - March</option>
<option value="4">4 - April</option>
<option value="5">5 - May</option>
<option value="6">6 - June</option>
<option value="7">7 - July</option>
<option value="8">8 - August</option>
<option value="9">9 - September</option>
<option value="10">10 - October</option>
<option value="11">11 - November</option>
<option value="12">12 - December</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="day" data-isrequired="yes" data-isfield="yes" id="participantadd6_day" data-dateset="participantadd6"
name="participantadd6_day" data-humantitle="Seventh <span class="participant_namefor_possessive">Participant's</span> - Day">
<option value="">- Day -</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="year" data-isrequired="yes" data-isfield="yes" id="participantadd6_year" data-dateset="participantadd6"
name="participantadd6_year" data-humantitle="Seventh <span class="participant_namefor_possessive">Participant's</span> - Year"><!-- THERE IS A DUMB BUG IF THIS VALUE ISNT AFTER 2008 PREFILL DOESNT WORK -->
<option value="">- Year -</option>
<option value="2024">2024</option>
<option value="2023">2023</option>
<option value="2022">2022</option>
<option value="2021">2021</option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1923">1923</option>
<option value="1922">1922</option>
<option value="1921">1921</option>
<option value="1920">1920</option>
<option value="1919">1919</option>
<option value="1918">1918</option>
<option value="1917">1917</option>
<option value="1916">1916</option>
<option value="1915">1915</option>
</select></div>
</div>
</div>
</div>
</td>
</tr>
</tbody>
</table>
</div>
<div class="section_minor curved_corner_div" data-additionalminor-pos="7" style="display: none; visibility: hidden;">
<div class="dob_default_location dob_default_location_participantadd7"></div>
<table cellpadding="10" border="0" width="100%">
<tbody>
<tr valign="top">
<td>
<div class="section_body">
<div class="section_title">Eighth <span class="participant_namefor_possessive">Participant's</span> Name</div>
<div class="offset_under_section_title">
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="12" type="text" data-isnamefirst="yes" data-checkcapitalization="yes" placeholder="First Name"
data-humantitle="First Name" autocomplete="one-time-code" data-titleforvalidation="Eighth Participant" name="participantadd7_firstname" id="participantadd7_firstname" value=""><br><span class="swform_title">First Name<span
class="swform_reqasterisks">*</span></span></div>
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="27" type="text" data-isnamelast="yes" data-checkcapitalization="yes" placeholder="Last Name"
data-humantitle="Last Name" autocomplete="one-time-code" name="participantadd7_lastname" id="participantadd7_lastname" value=""><br><span class="swform_title">Last Name<span class="swform_reqasterisks">*</span></span>
</div>
</div>
</div>
</td>
</tr>
<tr id="table_row_participantadd7_dob">
<td>
<div class="section_body">
<div id="participantadd7_dob_title" class="section_title">Eighth <span class="participant_namefor_possessive">Participant's</span> Date of Birth<span class="swform_reqasterisks">*</span></div>
<div class="offset_under_section_title">
<div style="margin: 0; padding: 0;" id="dob_all_wrapper_participantadd7" class="dob_all_wrapper">
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="month" data-isrequired="yes" data-isfield="yes" id="participantadd7_month" data-dateset="participantadd7"
name="participantadd7_month" data-humantitle="Eighth <span class="participant_namefor_possessive">Participant's</span> - Month">
<option value="">- Month -</option>
<option value="1">1 - January</option>
<option value="2">2 - February</option>
<option value="3">3 - March</option>
<option value="4">4 - April</option>
<option value="5">5 - May</option>
<option value="6">6 - June</option>
<option value="7">7 - July</option>
<option value="8">8 - August</option>
<option value="9">9 - September</option>
<option value="10">10 - October</option>
<option value="11">11 - November</option>
<option value="12">12 - December</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="day" data-isrequired="yes" data-isfield="yes" id="participantadd7_day" data-dateset="participantadd7"
name="participantadd7_day" data-humantitle="Eighth <span class="participant_namefor_possessive">Participant's</span> - Day">
<option value="">- Day -</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="year" data-isrequired="yes" data-isfield="yes" id="participantadd7_year" data-dateset="participantadd7"
name="participantadd7_year" data-humantitle="Eighth <span class="participant_namefor_possessive">Participant's</span> - Year"><!-- THERE IS A DUMB BUG IF THIS VALUE ISNT AFTER 2008 PREFILL DOESNT WORK -->
<option value="">- Year -</option>
<option value="2024">2024</option>
<option value="2023">2023</option>
<option value="2022">2022</option>
<option value="2021">2021</option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1923">1923</option>
<option value="1922">1922</option>
<option value="1921">1921</option>
<option value="1920">1920</option>
<option value="1919">1919</option>
<option value="1918">1918</option>
<option value="1917">1917</option>
<option value="1916">1916</option>
<option value="1915">1915</option>
</select></div>
</div>
</div>
</div>
</td>
</tr>
</tbody>
</table>
</div>
<div class="section_minor curved_corner_div" data-additionalminor-pos="8" style="display: none; visibility: hidden;">
<div class="dob_default_location dob_default_location_participantadd8"></div>
<table cellpadding="10" border="0" width="100%">
<tbody>
<tr valign="top">
<td>
<div class="section_body">
<div class="section_title">Ninth <span class="participant_namefor_possessive">Participant's</span> Name</div>
<div class="offset_under_section_title">
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="12" type="text" data-isnamefirst="yes" data-checkcapitalization="yes" placeholder="First Name"
data-humantitle="First Name" autocomplete="one-time-code" data-titleforvalidation="Ninth Participant" name="participantadd8_firstname" id="participantadd8_firstname" value=""><br><span class="swform_title">First Name<span
class="swform_reqasterisks">*</span></span></div>
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="27" type="text" data-isnamelast="yes" data-checkcapitalization="yes" placeholder="Last Name"
data-humantitle="Last Name" autocomplete="one-time-code" name="participantadd8_lastname" id="participantadd8_lastname" value=""><br><span class="swform_title">Last Name<span class="swform_reqasterisks">*</span></span>
</div>
</div>
</div>
</td>
</tr>
<tr id="table_row_participantadd8_dob">
<td>
<div class="section_body">
<div id="participantadd8_dob_title" class="section_title">Ninth <span class="participant_namefor_possessive">Participant's</span> Date of Birth<span class="swform_reqasterisks">*</span></div>
<div class="offset_under_section_title">
<div style="margin: 0; padding: 0;" id="dob_all_wrapper_participantadd8" class="dob_all_wrapper">
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="month" data-isrequired="yes" data-isfield="yes" id="participantadd8_month" data-dateset="participantadd8"
name="participantadd8_month" data-humantitle="Ninth <span class="participant_namefor_possessive">Participant's</span> - Month">
<option value="">- Month -</option>
<option value="1">1 - January</option>
<option value="2">2 - February</option>
<option value="3">3 - March</option>
<option value="4">4 - April</option>
<option value="5">5 - May</option>
<option value="6">6 - June</option>
<option value="7">7 - July</option>
<option value="8">8 - August</option>
<option value="9">9 - September</option>
<option value="10">10 - October</option>
<option value="11">11 - November</option>
<option value="12">12 - December</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="day" data-isrequired="yes" data-isfield="yes" id="participantadd8_day" data-dateset="participantadd8"
name="participantadd8_day" data-humantitle="Ninth <span class="participant_namefor_possessive">Participant's</span> - Day">
<option value="">- Day -</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="year" data-isrequired="yes" data-isfield="yes" id="participantadd8_year" data-dateset="participantadd8"
name="participantadd8_year" data-humantitle="Ninth <span class="participant_namefor_possessive">Participant's</span> - Year"><!-- THERE IS A DUMB BUG IF THIS VALUE ISNT AFTER 2008 PREFILL DOESNT WORK -->
<option value="">- Year -</option>
<option value="2024">2024</option>
<option value="2023">2023</option>
<option value="2022">2022</option>
<option value="2021">2021</option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1923">1923</option>
<option value="1922">1922</option>
<option value="1921">1921</option>
<option value="1920">1920</option>
<option value="1919">1919</option>
<option value="1918">1918</option>
<option value="1917">1917</option>
<option value="1916">1916</option>
<option value="1915">1915</option>
</select></div>
</div>
</div>
</div>
</td>
</tr>
</tbody>
</table>
</div>
<div class="section_minor curved_corner_div" data-additionalminor-pos="9" style="display: none; visibility: hidden;">
<div class="dob_default_location dob_default_location_participantadd9"></div>
<table cellpadding="10" border="0" width="100%">
<tbody>
<tr valign="top">
<td>
<div class="section_body">
<div class="section_title">Tenth <span class="participant_namefor_possessive">Participant's</span> Name</div>
<div class="offset_under_section_title">
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="12" type="text" data-isnamefirst="yes" data-checkcapitalization="yes" placeholder="First Name"
data-humantitle="First Name" autocomplete="one-time-code" data-titleforvalidation="Tenth Participant" name="participantadd9_firstname" id="participantadd9_firstname" value=""><br><span class="swform_title">First Name<span
class="swform_reqasterisks">*</span></span></div>
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="27" type="text" data-isnamelast="yes" data-checkcapitalization="yes" placeholder="Last Name"
data-humantitle="Last Name" autocomplete="one-time-code" name="participantadd9_lastname" id="participantadd9_lastname" value=""><br><span class="swform_title">Last Name<span class="swform_reqasterisks">*</span></span>
</div>
</div>
</div>
</td>
</tr>
<tr id="table_row_participantadd9_dob">
<td>
<div class="section_body">
<div id="participantadd9_dob_title" class="section_title">Tenth <span class="participant_namefor_possessive">Participant's</span> Date of Birth<span class="swform_reqasterisks">*</span></div>
<div class="offset_under_section_title">
<div style="margin: 0; padding: 0;" id="dob_all_wrapper_participantadd9" class="dob_all_wrapper">
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="month" data-isrequired="yes" data-isfield="yes" id="participantadd9_month" data-dateset="participantadd9"
name="participantadd9_month" data-humantitle="Tenth <span class="participant_namefor_possessive">Participant's</span> - Month">
<option value="">- Month -</option>
<option value="1">1 - January</option>
<option value="2">2 - February</option>
<option value="3">3 - March</option>
<option value="4">4 - April</option>
<option value="5">5 - May</option>
<option value="6">6 - June</option>
<option value="7">7 - July</option>
<option value="8">8 - August</option>
<option value="9">9 - September</option>
<option value="10">10 - October</option>
<option value="11">11 - November</option>
<option value="12">12 - December</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="day" data-isrequired="yes" data-isfield="yes" id="participantadd9_day" data-dateset="participantadd9"
name="participantadd9_day" data-humantitle="Tenth <span class="participant_namefor_possessive">Participant's</span> - Day">
<option value="">- Day -</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-datepart="year" data-isrequired="yes" data-isfield="yes" id="participantadd9_year" data-dateset="participantadd9"
name="participantadd9_year" data-humantitle="Tenth <span class="participant_namefor_possessive">Participant's</span> - Year"><!-- THERE IS A DUMB BUG IF THIS VALUE ISNT AFTER 2008 PREFILL DOESNT WORK -->
<option value="">- Year -</option>
<option value="2024">2024</option>
<option value="2023">2023</option>
<option value="2022">2022</option>
<option value="2021">2021</option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1923">1923</option>
<option value="1922">1922</option>
<option value="1921">1921</option>
<option value="1920">1920</option>
<option value="1919">1919</option>
<option value="1918">1918</option>
<option value="1917">1917</option>
<option value="1916">1916</option>
<option value="1915">1915</option>
</select></div>
</div>
</div>
</div>
</td>
</tr>
</tbody>
</table>
</div>
<div data-age-min="0" data-age-max="0" class="section curved_corner_div" id="div_sectionemail">
<table border="0">
<tbody>
<tr>
<td>
<div class="section_title" id="section_title_primaryemail"><span id="emailaddress_parentpossessive_span" class="showifminor_is_in_play"><span class="parentorguardian_namefor_possessive">Parent or Guardian's</span></span> Email
Address</div>
<div class="offset_under_section_title">
<table border="0">
<tbody>
<tr>
<td>
<div class="swform_formfield"><input data-isfield="yes" type="email" autocorrect="off" autocapitalize="off" data-isemail="yes" data-isprimaryemail="yes" name="primary_email" id="primary_email" size="30"
autocomplete="one-time-code" data-humantitle="Email" data-isrequired="no" value="" placeholder="Email"><br><span class="swform_title">Email</span></div>
</td>
</tr>
<tr id="table_row_email_copy_sent">
<td><input type="hidden" name="emailcustomercopyofdoc" value="1">A signed copy of this waiver will be sent to the email address you provide.</td>
</tr>
</tbody>
</table>
</div>
</td>
</tr>
</tbody>
</table>
</div>
<div data-age-min="0" data-age-max="0" class="section curved_corner_div">
<div class="section_title">Emergency Contact</div>
<div class="offset_under_section_title">
<table border="0">
<tbody>
<tr>
<td>
<div class="swform_formfield"><input data-isfield="yes" type="text" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="12" data-checkcapitalization="yes" name="emergency_contact_firstname"
id="emergency_contact_firstname" autocomplete="one-time-code" data-humantitle="First Name" onblur="warnIfEmergencyNameMatches()" data-em-firstname="yes" placeholder="First Name" value=""><br><span class="swform_title">First
Name<span class="swform_reqasterisks">*</span></span></div>
<div class="swform_formfield"><input data-isfield="yes" type="text" autocorrect="off" autocapitalize="off" data-checkcapitalization="yes" data-isrequired="yes" onblur="warnIfEmergencyNameMatches()" size="27"
name="emergency_contact_lastname" id="emergency_contact_lastname" autocomplete="one-time-code" data-humantitle="Last Name" data-em-lastname="yes" placeholder="Last Name" value=""><br><span class="swform_title">Last Name<span
class="swform_reqasterisks">*</span></span></div>
</td>
</tr><!-- TODO REMOVE: OLD NAME -->
<tr>
<td>
<div class="swform_formfield"><input data-isfield="yes" type="tel" autocorrect="off" autocapitalize="off" size="30" name="emergency_contact_phone" id="emergency_contact_phone" autocomplete="one-time-code" data-isphone="yes"
data-humantitle="Emergency Contact's Phone Number" data-isrequired="yes" placeholder="Emergency Contact's Phone Number" value=""><br><span class="swform_title">Emergency Contact's Phone Number<span
class="swform_reqasterisks">*</span></span></div>
</td>
</tr>
</tbody>
</table>
</div>
</div>
<div class="section curved_corner_div" id="div_sectionforparentorguard" data-age-min="0" data-age-max="17" style="display: none; visibility: hidden;">
<div class="parent_verbiage" id="div_parent_verbiage"> Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of
this document, as set forth above. <div id="div_parent_verbiage_extension" style="display: none;"><span><br><br> By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this
document, as set forth above. </span></div>
</div>
<div class="dob_default_location dob_default_location_parentofminor"></div>
<table cellpadding="10" border="0" width="100%">
<tbody>
<tr valign="top">
<td>
<div class="section_body">
<div class="section_title"><span class="parentorguardian_namefor_possessive">Parent or Guardian's</span> Name</div>
<div class="offset_under_section_title">
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="12" type="text" data-isnamefirst="yes" data-checkcapitalization="yes" placeholder="First Name"
data-humantitle="First Name" autocomplete="one-time-code" data-titleforvalidation="Parent or Guardian" name="parentofminor_firstname" id="parentofminor_firstname" value=""><br><span class="swform_title">First Name<span
class="swform_reqasterisks">*</span></span></div>
<div class="swform_formfield"><input data-isfield="yes" autocorrect="off" autocapitalize="off" data-isrequired="yes" size="27" type="text" data-isnamelast="yes" data-checkcapitalization="yes" placeholder="Last Name"
data-humantitle="Last Name" autocomplete="one-time-code" name="parentofminor_lastname" id="parentofminor_lastname" value=""><br><span class="swform_title">Last Name<span class="swform_reqasterisks">*</span></span></div>
</div>
</div>
</td>
</tr>
<tr id="table_row_parentofminor_dob">
<td><span data-onlyifparentofminorisparticipating="yes">
<div class="section_body">
<div id="parentofminor_dob_title" class="section_title"><span class="parentorguardian_namefor_possessive">Parent or Guardian's</span> Date of Birth<span class="swform_reqasterisks">*</span></div>
<div class="offset_under_section_title">
<div style="margin: 0; padding: 0;" id="dob_all_wrapper_parentofminor" class="dob_all_wrapper">
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-isparent="yes" data-datepart="month" data-isrequired="yes" data-isfield="yes" id="parentofminor_month"
data-dateset="parentofminor" name="parentofminor_month" data-humantitle="Parent or Guardian's - Month">
<option value="">- Month -</option>
<option value="1">1 - January</option>
<option value="2">2 - February</option>
<option value="3">3 - March</option>
<option value="4">4 - April</option>
<option value="5">5 - May</option>
<option value="6">6 - June</option>
<option value="7">7 - July</option>
<option value="8">8 - August</option>
<option value="9">9 - September</option>
<option value="10">10 - October</option>
<option value="11">11 - November</option>
<option value="12">12 - December</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-isparent="yes" data-datepart="day" data-isrequired="yes" data-isfield="yes" id="parentofminor_day" data-dateset="parentofminor"
name="parentofminor_day" data-humantitle="Parent or Guardian's - Day">
<option value="">- Day -</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select></div>
<div class="swform_formfield is_a_div_around_a_date_field" data-isadobdiv="yes"><select data-isparent="yes" data-datepart="year" data-isrequired="yes" data-isfield="yes" id="parentofminor_year" data-dateset="parentofminor"
name="parentofminor_year" data-humantitle="Parent or Guardian's - Year"><!-- THERE IS A DUMB BUG IF THIS VALUE ISNT AFTER 2008 PREFILL DOESNT WORK -->
<option value="">- Year -</option>
<option value="2024">2024</option>
<option value="2023">2023</option>
<option value="2022">2022</option>
<option value="2021">2021</option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1923">1923</option>
<option value="1922">1922</option>
<option value="1921">1921</option>
<option value="1920">1920</option>
<option value="1919">1919</option>
<option value="1918">1918</option>
<option value="1917">1917</option>
<option value="1916">1916</option>
<option value="1915">1915</option>
</select></div>
</div>
</div>
</div>
</span></td>
</tr>
<tr>
<td id="ctlSignatureB_Participant_container">
<div id="ctlSignatureB_Container_title" class="section_title"><span class="parentorguardian_namefor_possessive">Parent or Guardian's</span> Signature<span class="swform_reqasterisks">*</span></div>
<div id="ctlSignatureB_Container_TypeOrDraw">
<div id="ctlSignatureB_Header" class="sig_header">
<div class="sig_header_choice fl"><input id="ctlSignatureB_RadioType" name="ctlSignatureB_Radio" type="radio"><label for="ctlSignatureB_RadioType" class="sig_header_choice_label"> Type Signature</label></div>
<div class="sig_header_choice fr"><input id="ctlSignatureB_RadioDraw" name="ctlSignatureB_Radio" type="radio" checked="checked"><label for="ctlSignatureB_RadioDraw" class="sig_header_choice_label"> Draw
Signature</label></div>
</div>
<div id="ctlSignatureB_Body" style="display:none;position: relative;">
<div id="ctlSignatureB_Type">
<div class="sig_type_table">
<div class="div_tr">
<div class="div_tc" style="height: 35%;"><input type="text" size="30" maxlength="64" placeholder="Type your name to sign..." id="ctlSignatureB_TypeSign" name="ctlSignatureB_TypeSign" class="sig_type_sign_input"></div>
</div>
<div class="div_tr" style="width: 100%;margin-bottom: 70px;">
<div class="div_tc">
<div id="ctlSignatureB_TypePreviewParent" class="sig_type_sign_preview_parent">
<div id="ctlSignatureB_TypePreview" class="sig-preview font-dancing" style="display: inline"></div>
</div><br><a href="javascript:changeSigFont('ctlSignatureB');" id="ctlSignatureB_TypeFontChanger" class="change_sig_font" style="display: none;">Change Font</a>
</div>
</div>
<div class="div_tr">
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For Titletown's most up to date privacy policy please visit: https://www.titletown.com/privacy-policy Close Loading... RELEASE AND WAIVER OF LIABILITY TITLETOWN PUMPKIN PALOOZA CARVING 2024 Review Titletown's Privacy Policy -- READ BEFORE SIGNING -- The undersigned participant, or minor participant(s), by and through his/her/their parents or guardians (collectively the “Participant”) desires to participate in pumpkin carving at Titletown Pumpkin Palooza, currently scheduled for October 19, 2024 (the “Activity”). Participant understands and acknowledges that there are serious risks (collectively, the “Risks”) inherent in participating in the Activity, including but not limited to the risk of: exposure to communicable diseases, viruses, bacteria, or illnesses or the causes thereof (including but not limited to COVID-19 or its variants); minor and serious bodily injury, including severe or minor cuts, punctures, or wounds, scratches, bruises, sprains, and injury to the head, neck or spine, muscles, bones, ligaments, tendons, connective tissues, and internal and external organs; allergic or other reaction to the pumpkin or the utensils; loss of or damage to sight, hearing, or teeth; nerve damage or compression; stroke; heart strain and problems, including heart attack; loss of or damage to equipment/property; emotional or psychological injury; pain; scarring and disfigurement; injuries or impairment to other aspects of my body, general health, and well-being; permanent trauma; paralysis; and death, and that severe social and economic losses might result such as long or short term disability, loss of income, career opportunities or the enjoyment of life, which may be caused by, without limitation: injuring caused by carving utensils; the condition of the carving area; equipment failure; inadequate safety measures; participants of varying skill levels; exhaustion/overheating/dehydration due to temperature; close physical contact/crowding with other participants, spectators, animals and insects, or other natural or manmade objects; my own actions or inactions; the actions or inactions of others participating in the Activity; the conditions in which the Activity takes place; the rules of operation; changes in weather conditions; exceeding one’s own abilities; and/or the negligence of the “Releasees” named below. I further acknowledge that any instruction, supervision, and enforcement of rules by the “Releasees” named below do not and cannot guarantee my safety, and may be incomplete or imperfect. I understand I am responsible for determining whether I am physically and medically able to participate in the Activity. In addition, I fully understand that there may be other, additional risks either known or unknown to me, or not readily foreseeable at this time. In exchange for the permission granted to me to participate in any way in the Activity by Titletown Development, LLC (“Titletown”), the undersigned Participant accepts and assumes complete and absolute responsibility for all Risks encountered by Participant as a result of their purely voluntary participation in the Event. The Participant agrees to release, hold harmless and indemnify Titletown Development, LLC, Green Bay Packers, Inc., the National Football League and its professional member clubs, Delaware North Companies, Inc., Titletown Sportservice, Inc., H.J. Martin and Son, and their respective agents, assigns, owners, affiliates, officers, directors, and insurers (collectively, the “Releasees”) from any actions, suits, damages, claims, or judgments that may result from any personal injury, property damage, or death which the Participant may sustain while participating in the Event, even if the injury or damage is caused by the negligent act or omission of the Releasees or its agent. This release of liability shall be a full and final compromise and settlement of any claims for any injury or damage suffered by the Participant as a result of the Activity. Nothing in this Release shall be construed as a release, discharge, or waiver any claim that Participant may have for reckless or intentional acts of the Releasees or their respective agents. In addition, the Participant further agrees to indemnify the Releasees, and their respective agents, assigns, owners, corporate subsidiaries, affiliates and parents, officers, directors, and insurers, from any and all actions, suits, damages, claims, or judgments that may result from any personal injury or property damage which any other persons may sustain as a result of the Participant’s conduct during or relating to the Activity. Participant agrees that if any portion of this Agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect. If there are any disputes regarding this Agreement, Participant hereby waives any right I or anyone on my behalf may have to a trial and agree that such dispute shall be determined by binding arbitration before three neutral American Arbitration Association arbitrators in Green Bay, Wisconsin. Each Party shall be responsible for their own costs and expenses issued in connection with the arbitration, suit or action, including attorney's fees and costs at the arbitration, suit or action and to enforce any arbitration award in court and on appeal. TITLETOWN AND PARTICIPANT AGREE THAT ALL DISPUTES SHALL BE ARBITRATED ON AN INDIVIDUAL BASIS AND WAIVE ANY RIGHT TO LITIGATE OR ARBITRATE ANY CLAIM AS A CLASS ACTION, REPRESENTATIVE ACTION, OR CLASS ARBITRATION. IF PARTICIPANT DOES NOT CONSENT TO THIS CLAUSE, HOLDER MUST NOT PARTICIPATE IN THE ACTIVITIES. THIS CLAUSE IS GOVERNED BY THE FEDERAL ARBITRATION ACT. Participant authorizes the Releasees, and anyone authorized by them, to retouch or alter their carved pumpkin, or any photographs, video, or other media taken of the event Participant and use them, in whole or in part, with or without the Participant’s name, signature, and/or biographical information or other identification of any other fictitious or real person, in any and all media, for advertising or commercial purpose, and to claim and register its copyright in same; and further, release and hold harmless the Releasees and their respective employees, directors, officers, agents, successors, and assigns from any and all liability arising from the use of the Participant’s pumpkin and/or the Participant’s photograph and from any blurring, distortion or optical illusion which may occur or be produced, as well as from the use of the Participant’s name, signature, and/or biographical information; and further relinquish all right, title and interest in and to the pumpkin and any photograph or media of Participant, the negatives and prints and their reproduction, including the right to approve their final form, context and use. Statement of Understanding: The undersigned has read and understands this document, and enters into it on behalf of the Participant and Participant’s family, spouse, heirs, executors and assigns, and anyone acting on Participant’s behalf, including attorneys, agents, insurers and representatives. The undersigned also acknowledges that the undersigned has had sufficient time to read this document, has had the opportunity to consider the consequences of signing this Agreement, and has had an adequate opportunity to ask questions regarding this Agreement. I HAVE CONSIDERED THAT IF THIS WAIVER OF LIABILITY WERE NOT AS BROAD AS IT IS, THE COST FOR MY PARTICIPATION IN THE ACTIVITY WOULD BE CONSIDERABLE, AND AS I DO NOT WISH TO PAY A CONSIDERABLY HIGH COST, I WAIVE THE RIGHT TO BARGAIN FOR DIFFERENT WAIVER OF LIABILITY TERMS. Please select who will be participating... AdultMinor(s)Adult and Minor(s) 1 Minor2 Minors3 Minors4 Minors5 MinorsMore Minors6 Minors7 Minors8 Minors9 Minors10 Minors Continue First Participant's Name First Name* Last Name* First Participant's Date of Birth* - Month -1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December - Day -12345678910111213141516171819202122232425262728293031 - Year -20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915 First Participant's Signature* Type Signature Draw Signature Change Font Accept SignatureClear Close Please sign Accept SignatureClear Close Click to Sign Edit Signature Second Participant's Name First Name* Last Name* Second Participant's Date of Birth* - Month -1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December - Day -12345678910111213141516171819202122232425262728293031 - Year -20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915 Third Participant's Name First Name* Last Name* Third Participant's Date of Birth* - Month -1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December - Day -12345678910111213141516171819202122232425262728293031 - Year -20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915 Fourth Participant's Name First Name* Last Name* Fourth Participant's Date of Birth* - Month -1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December - Day -12345678910111213141516171819202122232425262728293031 - Year -20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915 Fifth Participant's Name First Name* Last Name* Fifth Participant's Date of Birth* - Month -1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December - Day -12345678910111213141516171819202122232425262728293031 - Year -20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915 Sixth Participant's Name First Name* Last Name* Sixth Participant's Date of Birth* - Month -1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December - Day -12345678910111213141516171819202122232425262728293031 - Year -20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915 Seventh Participant's Name First Name* Last Name* Seventh Participant's Date of Birth* - Month -1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December - Day -12345678910111213141516171819202122232425262728293031 - Year -20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915 Eighth Participant's Name First Name* Last Name* Eighth Participant's Date of Birth* - Month -1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December - Day -12345678910111213141516171819202122232425262728293031 - Year -20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915 Ninth Participant's Name First Name* Last Name* Ninth Participant's Date of Birth* - Month -1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December - Day -12345678910111213141516171819202122232425262728293031 - Year -20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915 Tenth Participant's Name First Name* Last Name* Tenth Participant's Date of Birth* - Month -1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December - Day -12345678910111213141516171819202122232425262728293031 - Year -20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915 Parent or Guardian's Email Address Email A signed copy of this waiver will be sent to the email address you provide. Emergency Contact First Name* Last Name* Emergency Contact's Phone Number* Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above. By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above. Parent or Guardian's Name First Name* Last Name* Parent or Guardian's Date of Birth* - Month -1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December - Day -12345678910111213141516171819202122232425262728293031 - Year -20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915 Parent or Guardian's Signature* Type Signature Draw Signature Change Font Accept SignatureClear Close Please sign Accept SignatureClear Close Click to Sign Edit Signature Electronic Signature Consent* By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary. One or more problems exist. Please scroll up. Agree To This Document Powered by Smartwaiver - TRY IT FREE!