Contact Telephone Number. I authorize the following individuals to collect my child from the facility in case of emergency or if I cannot be contacted: (Pursuant to R9-5-304.B, at least two contact persons are required.) Name: Contact Telephone Number: Name: Contact Telephone Number:
Contact Telephone Number. A Health Care Provider is a physician, physician assistant or registered nurse practitioner. I hereby give authority to any hospital or doctor to render immediate aid as might be required at the time for his/her health and safety. The following individual(s) may NOT remove my child from the facility: Name(s): Custody papers have been provided and are on file at the facility. yes no Telephone Authorization Code (optional):
Contact Telephone Number. Contact Fax Telephone Number: ------------------------------------------- Contact Email Address: --------------------------------------------------
Contact Telephone Number. Please list each Food & Beverage item that will be served as samples at the event. Food & Beverage Item Description Key Ingredient of the Food & Beverage Item Source of the Food & Beverage Item (Name of Whole-Seller/Outlet) For example: Wonton For example: Pork, Prawn For example: Pork – XXX Whole-Seller Name Prawn – YYY Whole-Seller Name Food & Beverage items not listed but found at the event will not be allowed, and the Licensor has the right to remove such items.
Contact Telephone Number. Services
Contact Telephone Number. Please list each Food & Beverage retail item that will be sold at the event. Food & Beverage Item Description Key Ingredient of the Food & Beverage Item Source of the Food & Beverage Item (Name of Whole-Seller/Outlet) For example: Wonton For example: Pork, Prawn For example: Pork – XXX Whole-Seller Name Prawn – YYY Whole-Seller Name
Contact Telephone Number. Email address for service of notice or document: :Insert full name of tenant 3 How/where is the rent to be paid: In accordance with Additional Term 4 of this agreement. List all appliances or devices provided as part of the agreement that the tenant should expect instructions for e.g. air conditioner:
Contact Telephone Number. If a Settlement Class Member fails to fully complete a Claim Form, the Claim Form will be invalid. Any Settlement Class Member who submits an incomplete or inaccurate Claim Form shall be permitted to re-submit a Claim Form within 35 days of the sending of notice of the defect by the Claims Administrator. Class Counsel shall be kept apprised of the volume and nature of defective claims and allowed to communicate with Settlement Class Members as they deem appropriate to cure such deficiencies.
Contact Telephone Number. The Term of the Agreement shall commence on the Effective Date and shall continue for one year, unless earlier terminated pursuant to Section 5. All terms and conditions of the Agreement not amended by virtue of this Amendment shall remain in full force and effect.
Contact Telephone Number. Contact E-mail Address
