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HANPlCAPPED CHILD AREA <br />WARNING SIGN REGISTEATION <br /> <br /> (Please Print) <br /> <br />NAME <br /> (parent~ <br /> <br />ADDRESS <br /> <br />/ <br /> -(-child) <br /> <br />HOME PHONE: <br /> <br />WORK PHONE <br /> <br />Discription of Child's Handicap <br /> <br />Note: Upon'request, the registrant shall pr~¥ide 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 />attent'ion we pay to our children when they are outside. <br /> <br />Signature Date <br /> <br /> <br />