I, the undersigned parent or legal
guardian of above named children will not hold Kaleidoscope,
its agents, servants or employees responsible for any
accidents incurred during participation in the Kaleidoscope
program. If parents or doctor cannot be reached in case of
emergency, consent is hereby given that the student receive
medical treatment and/or surgical care as recommended by
physician or hospital.
Your typed name is considered your
signature
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Please click the submit button below to send your
registration or print and then fax or mail this form.
If check is not mailed within 24 hours, registration
cannot be confirmed.
Please make checks payable to KALEIDOSCOPE and mail
directly to:
KALEIDOSCOPE
BOX 506
ANDOVER, MA 01810
Any questions?
Please call (978) 475-1422 days, nights and weekends and
leave a message.
Print a copy of this form now for your records
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click submit first, then the PayPal link in the
registration menu