OLD TOWN-ORONO YMCALiability and Indemnity Agreement • April 30th, 2018
Contract Type FiledApril 30th, 2018Please Indicate with whom the child lives: Mother Father Guardian Please indicate if Parents are: Single Married Divorced
OLD TOWN-ORONO YMCALiability and Indemnity Agreement • March 31st, 2017
Contract Type FiledMarch 31st, 2017Primary Parent’s Information Secondary Parent’s Information Name: __________________________________________ Name: _______________________________________________ Home Phone: _________________________________ Home Phone: ______________________________________ Work Phone: __________________________________ Work Phone: _______________________________________ Cell Phone: ____________________________________ Cell Phone: _________________________________________ Employer: ______________________________________ Employer: ___________________________________________ EmployerPhone: __________________________________________ EmployerPhone: ______________________________________________ EmployerAddress: _______________________________________ EmployerAddress: _____________________________________________ Employer MailingAddress: _______________________________________ Employer MailingAddress: _____________________________________________ Job Title: _______________________________________ Job Titl