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I hereby, for myself, and heirs, executors, and administrators, waive and release all rights and claims for damages I may have against Sensible Solutions Care Clinic, and/or their respective agents, representatives, successors, and assigns for any and for all injuries which may be suffered by me in connection with any participation in all programs or events.  I give my permission for my photo to be used by SSCC for promotional purposes both in print and on their website.

Pay registration fee via venmo to 
@Sensiblesolutionscareclinic or by cash/check at the office.

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