Parent Waiver For Minors

Minor Release Form
I, blanks* , give my permission for my son/daughter, blank* , to be seen at The Teal Center at his/her will.
Signature*

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Date*

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Date
4001 North Ninth St., * Ste. 230 * Arlington, VA 22203

703-522-7637 * www.tealcenter.com * feelbetter@tealcenter.com
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Minor Release Form