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* 1. Please provide full names and ages of all who will be attending in your family.

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* 2. Email Address

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* 3. Phone Number

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* 4. Assumption of the Risk and Waiver of Liability

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my attendance at the Mississippi Aquarium Community Event, 10/4/2025, or participation in LHF programming (“Claims”). On behalf of my child(ren) and myself, I hereby release, covenant not to sue, discharge, and hold harmless the Louisiana Hemophilia Foundation, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs, or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Louisiana Hemophilia Foundation, its employees, agents, and representatives.

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* 5. Accident/Injury Liability Waiver

I, the undersigned, being aware of my own health, limitations, and physical condition, acknowledge that I am voluntarily participating in the LHF Mississippi Aquarium Community Event, 10/4/2025.

Having such knowledge, I understand that I am solely responsible for my personal safety and hereby release LHF, its representatives, agents, and event site host from liability for any accidental injury that may result from participation in this program.

I also accept this liability on behalf of my child(ren), and furthermore agree to supervise adequately to prevent injury.

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* 6. Questions or comments? We welcome all.

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* 7. If your mailing address, email address, or phone number has changed in the last 6 months, please update in the comment box below.

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