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11400 TOWNSEND ROAD

MILAN, MI 48160

 

 

 

 

My minor child, ________________________________________, has my permission to

 

participate in motocross racing or motocross practice events at Twisted MX, located

 

at 11400 Townsend Road, Milan, MI 48160, on  _______/_______/_______.  In addition, I

 

give permission to ________________________________________ (an adult), to sign all liability

 

release and registration forms required by Twisted MX, and to give consent for

 

medical treatment for (rider)_______________________________________ if needed.

 

 

___________________________________________________

Signature of Parent or Legal Guardian

 

 

____________________________________________________

Signature of Notary Republic (seal required)