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Submission: On October 26 via manual from IN — Scanned from CA
Submission: On October 26 via manual from IN — Scanned from CA
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We're sorry but Singenuity Kiosk doesn't work properly without JavaScript enabled. Please enable it to continue. FILL OUT A WAIVER We need your information whether you are completing this waiver for yourself or if you are a parent/guardian completing this waiver on behalf of a minor/child. You must be at least 18 years old to complete this form Personal Information EmailA valid email is required Your birthday MonthJanFebMarAprMayJunJulAugSeptOctNovDec Day12345678910111213141516171819202122232425262728293031 Year2024202320222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925 You must be at least 18 years old to complete this form First nameThis field is required Last nameThis field is required Country AfghanistanAlbaniaAlgeriaAndorraAngolaAntarcticaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia, Plurinational State OfBosnia And HerzegovinaBotswanaBrazilBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (keeling) IslandsColombiaComorosCongoCongo, The Democratic Republic Of TheCook IslandsCosta RicaCôte D'ivoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (malvinas)Faroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGuatemalaGuineaGuinea-bissauGuyanaHaitiHoly See (vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic OfIraqIrelandIsle Of ManIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic OfKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia, The Former Yugoslav Republic OfMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMayotteMexicoMicronesia, Federated States OfMoldova, Republic OfMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension And Tristan Da CunhaSaint Pierre And MiquelonSamoaSan MarinoSao Tome And PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province Of ChinaTajikistanTanzania, United Republic OfThailandTimor-lesteTogoTokelauTongaTrinidad And TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuela, Bolivarian Republic OfViet NamWallis And FutunaYemenZambiaZimbabwe This field is required ZIP / Postal codeThis field is required City & State This field is required Do you want to join our mailing list? YesNo Do you need to fill out a waiver for any minors under 18 years old? YesNo Next DeutschEspañolFrançais日本語한국어Português (Brasil)中文(简体) Powered by Localize English