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I <br /> / <br />i <br />! <br /> <br /> ! <br /> i <br />i <br />i <br /> <br /> .j <br /> NAj~D~CA.~?£D CHILD AREA <br />WAJ~ZNG SIGN REGISTRATION <br /> <br />(Please Print) <br />ADDRESS <br /> <br />/ <br /> (dh'il <br /> <br />HOME PHONE <br /> <br />WORK PHONE <br /> <br />Discriptimn of Child's Handicap. <br /> <br />Note: <br /> <br />Upon request, the registrant shall provide the City' with a medical <br />confirmation of the Child's handicap. <br /> <br />I, the.undersigned parent.or legal guardian of the above named handicapped <br />child, do understand that the subject signs may not provide an increased <br />level of protection or safety; and that we must not reduce the level of <br />att'ent'ion we pay to our children when they are outside. <br /> <br />Signature Date <br /> <br /> <br />