%PDF-1.3
%âãÏÓ
1 0 obj
<< 
/CreationDate (D:20010806113623)
/Producer (Acrobat Distiller 4.05 for Windows)
/Keywords ()
/Subject (Copy of Medical release form)
/Author (CzachJL)
/Creator (Adobe PageMaker 6.52)
/Title (Copy of Medical release form)
/ModDate (D:20010806122422-04'00')
>> 
endobj
2 0 obj
<< 
/Type /Pages 
/Kids [ 5 0 R ] 
/Count 1 
>> 
endobj
4 0 obj
<< 
/Type /Catalog 
/Pages 2 0 R 
/AcroForm 34 0 R 
>> 
endobj
5 0 obj
<< 
/Type /Page 
/Parent 2 0 R 
/Resources 6 0 R 
/Contents 10 0 R 
/MediaBox [ 0 0 612 792 ] 
/CropBox [ 0 0 612 792 ] 
/Rotate 0 
/Annots 40 0 R 
>> 
endobj
6 0 obj
<< 
/ProcSet [ /PDF /Text ] 
/Font << /F1 7 0 R /F3 8 0 R >> 
/XObject << /Fm2 22 0 R /Fm4 29 0 R >> 
/ExtGState << /GS2 16 0 R /GS3 30 0 R >> 
/ColorSpace << /Cs5 9 0 R >> 
>> 
endobj
7 0 obj
<< 
/Type /Font 
/Subtype /Type1 
/Encoding /WinAnsiEncoding 
/BaseFont /Helvetica 
>> 
endobj
8 0 obj
<< 
/Type /Font 
/Subtype /Type1 
/Encoding /WinAnsiEncoding 
/BaseFont /Helvetica-Bold 
>> 
endobj
9 0 obj
[ 
/CalRGB << /WhitePoint [ 0.9505 1 1.089 ] /Gamma [ 2.22221 2.22221 2.22221 ] 
/Matrix [ 0.4124 0.2126 0.0193 0.3576 0.71519 0.1192 0.1805 0.0722 0.9505 ] >> 

]
endobj
10 0 obj
<< /Length 2208 /Filter [ /ASCII85Decode /FlateDecode ] >> 
stream
8;Xu\gQL;L&q/qEoHUb$U'U8V2eQahSL!5TVHg:B8Sq<M,f/G.+fUF^cUdb^pAc<b
ai[R0jfQU(*`3(:EmEo=j&_/$,V.jgGqgV-PL)GS%L]3MeiTn6`QOLpVR%$k.S_p^
otC%K&e?$<>-9IFPDaqc_]n4g+[n#-6<[F@ijoLGn+:C^\pQ7iG9*#+XN<&AF(:i.
&!hWnHZOE0r*+JgqsEeBoTig2pZ?q5r*V7VpYudB4i[pZ$pFB*RJ-/+oor$Za7HZ,
D=#6Uc?n6oc]j.<V2=:p*F_UDZ0Z7Rq*;(iq14o+p[nGtQ\m4aN=,D(it=BJ<*=[3
3.<tRQW@k*?j;O!W'E0"T#8Fo+B@8Nk:0*s2,(N;otC=8bRUA<brsrUm,)H74+Z54
k00](=X@[$c<\Jss7;K$D!lX)[_Hr_LTY2A5Dbh@/9XAWLDdT2CbZ<WGqVL3p:/?T
R)A;mc"nGQ5AkqBrOi%H8BntdJom><-3Z<dr8)m/'WpT1B5ej$PJ&XJBZJ;G)0]sP
.#"qE3(7;37G;Cf=SsRkFPRWt"i(5upZ6jd0SeE(;[Mc;j-,/2P&7rci#3Y(c[Ea,
2T1,fj<d^ALn#819CM7II)L3S:!O@"]0K^C"D6*pD,a1KR0_4fQWZnZaS.9:TND#*
-!D#nm%&p,%F0M4$c(X'O5;/$GYhl#MRrh9#/NSMoQo9AiYh^,;(>84r(#/bNZe+Q
"1Bq+(.ZE&I+Pa?W++g_S=F$)1qeCTS(\bGieg`Q"e6%0V(>%6e4Mie#Q7#^]/hV>
KqRV2aKu@;6i:X?#[HgD<[D1,\aO8jgUEG]2knS.Zr:pBXm)XYhr=ZbS(2%O=hNO&
D'?5h@<#G7r3RqRhbXAIHmenT'k,gOD]@\EJAmS4DT$k^`"/VQT$5f3raS>Ynki5W
K<rL/a+B2];(b`@\6LYb]k#^gP;2*s6]E\2PuZBVk["rY8$Uq$h7h/!>ej=HbNd!l
Y9'mG`u+[EQL)VdXI/;a+Z-%>:V)2)Ju>1aIi/5io?jUZl4$:5;`>4EARu0B9@6Tm
$@+#Q?Ik2m<<FMP?8l_dR8\DQ7+"rK0^1ZMDJ.!BIF:Y[\,##?c^]GjE;tFZo._WT
punEH<;G2"=J.a_rC5kmVO!ib]g6QJZtm6JY%4NWJS'lOEp*^H5O9Q.XR"AEd>NSt
AA9EQjWGeK$`p#6WB47=<c^N6KANIiUl-[-5(t`9/?U)Y38UO3Z-mi\Xk*gY:@K"\
GPr@`.lO^!+o>Rb=)3QkG&=R"Z`;J41/)Gt@8t)BT5:q(O4V;8s8FiR_$k)=A).??
R2GAuaqC`W*0h`6`"a#mbI8ACWA;+'`V1K:JU@i&eT-'l8Kr_doB6R<fcui1%>PG\
e2]J5)'@RU\&4r;mB0EgZ6`B8b2shbOOFed.)0Q_>*SNSHccU).L!!iD/1TC_JEIi
\RH4[9[9'LL?dLeGkVM&'qEFb#h0T#RnVC=%iYbrb=kq>>SI/qXi*+Jf?2E".6-I<
*:g]MQ'ogd;#t3Y<Mr8LER+`*Ci7t-Sl?B8)mN]USJb*'RoZBB2_'K'gJlmLLK!Gp
*k!i]*g[bR':%7bh_m'LFQi^C('YlD+DrHlDe3(u2X?H&0'$s?QQ6H!I*='C)ro*-
n-6q2L08@t$)(>5a5a\3"F/TP>ErT/I3Cc0?3B$Bm1\!2ZpAQ'_\l(&4!u%0S8'Gn
`n7-1),p[%45))T<$.'kFC_/=q[ljIm+(Ic@`En.m;uq[.sd^8h/G?Y+O`rWR/ene
L73dMWB(U9/S##2CXM)GKDUaMVG9W0X',,BT7UNgmlfP"Q"p($r\Gn!o66_fM^InX
<nCqBc3^>:!h5HS%l7T+fa^9ib-"UL[BG7,^BVZbSq_4k;$AuR65?ONKo9Wi!f87)
R?k:0Rc7s*]#PRG7%MI0"L`66<lQ"o1X'MldC:,YrRQ_3@c*PG"V3f3<#k^l\2n:4
L$f(R0V%q&Ib!P^>cC>GW4Rh^eRWF!Uq6-9%!2B>7hB'SpCP5n&;%b<"e\AMo/ds.
#,0:S(r/;h`D[VF7!j3/1>3gc=5RW8YX@\>IgSdt.M%-G#<bd=8l^8o8PlU.Zg@8V
Gr[Ei\<9F5VO!i08\Sqc2:&tmY:rs*A_\o??S+M9SV/3EF2EGObkX*900[m!]qa:b
]M(>&3c"8[o'*$V^:4)#!3Dj\fD~>
endstream
endobj
11 0 obj
<< /Length 221 /Filter [ /ASCII85Decode /FlateDecode ] >> 
stream
8;Z]YOTNKE(^A?Zo5U/BL>a\R9uC,$%VM8*_f1utiK*"Q%)7/HiT`R%Duc\uX`I[l
j#!OKqjg7i8KtFBgMBn68*7;3AsVNg+W%9jC7L).`+Z:/O2Eu-h:EdG&/)C)f^/=#
KqHl@ZOnLXLF?nC$?n48I\GraO.&_.WZXKm1mGkk_\hHneRFWc<tKp#:Vu75hDd-@
0PUN``5)$>pOgclbW'-J~>
endstream
endobj
12 0 obj
[ 
/Indexed 9 0 R 255 11 0 R 
]
endobj
13 0 obj
<< /Type /XObject /Subtype /Image /Width 118 /Height 100 /BitsPerComponent 8 
/ColorSpace 12 0 R /Length 2981 /Filter [ /ASCII85Decode /FlateDecode ] >> 
stream
8;Z\7CNlLD&8`(BO\'p'EL\9sL`-^0^-E6(r;Ze3lTq;6S__7F$_O;:"q"o;;H:2D
(IJ&)5?>>FDJnc!2-DB*]Xr)q@,EGf]kK=k+)W/$[R/?pj8D>DLfRa/3n9q\gcn!]
=g)TOeY,1^B4,pe\%9`5)[b,?CfQ49e*&Ph>H:g0.XI/8mg.\"[!m.ri`ee9hXteE
Xfb`]W]uS9B_>tkTO@_Ra2`M@dR\kp4)i]g;m/4dMpD:7p)V"d5&/nWAZ3:h%:DI=
[>&FikNDEdU0#qb)FW7sBFS^II\Y:>&$FUM&8QE%RNHL_dBkf<J'623YoD?M)@n7o
29eAi^,(#;].J$oWBl^dL@N]E:%#uFD2Aa-_?HI;o(9Flf=KjW2<,EDg,67g1V<eM
=['UI\Lc3FcnBgbkaI%u;?O.9g%tdtUK_''[9fs>A83('*MWNeN14G25jO`4N)'tf
"OM&;&EW#]IFmk0DXl<$9kf`1:l*N`)YI948g-V6Y&A[K$&#B!g2"BM$UoI=hG\V[
L/I@Ee%?oVB\"?<*!fAZb66)W$$nFpr5qiu_Kg2ha0r$7m9de5*@`nkMeZ%$g$dIa
MY\1tg@`!#<0Z:3nm3i9f-!EI\KtF-TQ>5tF\UB_QYs@6s*&ffnlV@Gs3b(pO.)bb
b>\@hZK>)l\rTBt^kPe&AWuGEO#hAQ?t1!M-fBqQmT]LcQKu+,f:>6OBCGu\^R#H\
*'tZ?+]\uGG$V:F37B/DbRnnQ>/5iOW2&ScDp/0==ago5=#(&5[1o+t1(;(.0>s>Q
KgjJpTgFA(_.9fQfFB1_[bj4[g%I[d"52I\K;B)p4">ing?j'a(_1=iL-)gQ'GF@"
#t.L\,>Ujb+1[\Vi%u"onTZd@"5S)D8Bqe2?l),b!_VIi@5%<lkUmVH'Ibj?e;03Z
^fCXHGXFl4_=-i6W]?=(m2aJn%h=;&>m!]HJAZrnj-ig+!nY<%g4TUS!!2JL4!&o6
)Hf>8d9u)Gi3\;pq@rp]%aVZ&!haSEgP$?<0>Ljkm(TKs/bI#L'.i#!1lKGq2jnr$
]'[$&)"lKK]E>N>!#9:[Q2s7==PSG^R&#:0/HT4bKFZ1#FW2qbI&3f+(h8EAE(jPK
@7$XZm^.e=C]J!=1_L,+'&:jPaBU4R@-eLeYSr.^!0f["3tjV_]cn3u.eNeub['E9
:icsKic&LNetl3[$*e59R=n4hEfhX_"6OcMk=iJGX=/e-U.5QXgoZMoRi#""#KIEs
Gsi9&`/;i*OXJ(Z:M6sV\2t?l0ZTp['JQ8#8ef;=fr_RW")<VtbKB:72_53"[=nig
cWk"CMct_3In/K7Ts+gJ'W,\6OY]s1X[aaBkoH8A_g@JEGP$Wp7jQ^mN]c=P[0hF.
Nrjt=4VC`I>sPV+XtYk_81Gko/kc/a'P;R1RhJVC2T=k+Ad)#9U2._P+c^i24m"Fj
'Q%k5b`GEU/I2DSb'&WYT'J/`i%Yb,@TnH%l']DcT-Q2:.*UGW]:bs.Je`34bFRh!
NYHYBLL/DgOMW(C5_#Z8T9(0'c5[]Q50L)lPe@C7:sg`Y%CdXnU^I:+kSt(d.#e#3
3Ds%%6)G''gUaFl59^G55C/-I[AL[rJ]#Kb%^2S1A.%L952m)k;\^i:KZh)T'F_u=
+*(U]V@0"mFUkn]W$D_RM8JK!FiJ#=AS.07gk2I[hGQPaNVIWI#03W+,\m@l!,AS`
bh@Q_AkX57X^5H[.:=^pP['+pN8Sc'%K\g/TeOX:(@d^Oma2JX2Nj\>'$SNs&Ma#%
q?P%ui2mI[*U3"6r@B^++aK@SFj#J3p3E'6Wo(Z_4F2Q-\el68j2Q^i2_V30^7&2b
B/cYojMth`$&U8X]c_rRlBs8$lCl4q6K<tBQ*<]dB,=:9Au$D#]54#?6RgIZANoA;
dn*#ji?As?1]>5MBIYsc>Tmbt!BV`9SIN8Gk[\QF71N?pG8punlWBGtk*BQn+k+2n
r&bRkU5,/O%_1XS>[dUB'=n[H-hu`-->VtNFTQG!m)!&<`LYls_Jlt0pP=$[H[(<o
J@697-(`^=oA<An2TIs0ap=H7aC=!7OmXQ7:c./$c:hu5K-iT_p$4K6*liT$DH/1e
eV!H$jR,L;O+s3n\Z6-E8R4V$A?e1?JJ'!PN/ifK2n3=5@`02gM(oeImT^oPfKnMd
phP,M#HpD3%`DIh\s9fo`tq[ig#_JHgo3RQo$$+q"rprJfFJIWFHon"RFs\Nh-=8Q
rNo5$"A^<oSr\buIQC?)35!W7HV,\<RW9Aa:m;1&ahF#C:O^@/=^VWjr'VFb%l@Pk
&4;fRqA3'1\04,b0"h>\Qk+X&/u0:e=2ZYVA+^Q$()9-,Vgp#D9Yqk\RS+goGG9%-
M1@[O?M=fVkes\8?MIYRnfYQ?&$SH`9+S),'Hr;73S2N'7OVqnL<:TO,Q_bFGno8X
B/Tq__oHgBZ^kl!)g/r2;V^-8$tj>#Y`dSp19XRj^W:]$*eY^c2-VD/J:dJ>M,3q\
OF73cY:.QD)/>Z22KSV4/<t1/f4`*]0O8Rd9mTLX,=1:_#q(tmGe;l0bhLBk^JB[<
M<+1#lY@qs@N29?pM$_'okA#%0M,>fQg0M@WDF3u*IO"F6KV^TVlXmh8sE67D($i*
>^sl+V)k*Ibou\6206B.o2%023FJ._d3'%"omPE+>l+Wg+jtfPb`K8$PX,(c,3?On
9p^&&fSjO+AO50$2q.d$Dq_r@iU48tkL+#I8srr_V#Bgdqu'ch0rIOL1L.?J>T-I_
PHTK*F#IY`-ISe4K!etVCdHs6f4b1#_tCl#n!4?*)<Sja=%sSq^;PdW)s<.@j7t#D
O.]\RZOEq#%\:WVC+Dm]0P_@%:2q-oK\&+"+ABP[)]k,,r*kCF0FK<#n?[W6Ij\DU
8Q26p+lbCR'BL:"S#!)!'hQDb&gnVs-:nin(lf5Ak4n[!-*r*9])T_Q,5oQ'J#l?@
CB,4%5@a~>
endstream
endobj
14 0 obj
<< /FunctionType 0 /Domain [ 0 1 ] /Range [ 0 1 ] /BitsPerSample 8 /Size [ 256 ] 
/Length 345 /Filter [ /ASCII85Decode /FlateDecode ] >> 
stream
8;R<H!WW-!!<N?+"U52;#mq%K%1Wm[&J>`k'c%T&)&aG6*?H:F+X/-V,pjuf.4Qi!
/M8\10etOA2)[BQ3BB5a4[)(q5sdq,77Kd<8P2WL9hnJ\;,U=l<E<1'=^#$7?!^lG
@:E_WAS,RgBkhF"D/O92EH6,BF`qtRH$XgbI=?ZrJV&N-KnbA=M2I4MNK0']Ockom
Q'Rc(R@9V8SXuIHTq\<XV5C/hWN*##Xfek3Z*L^C[C3QS\[oDc]tV7s_8=+.`Q#s>
ai_fNc-FY^dF-Lne^i@)g"P39h;7&IiSrnYjlYail0@U$mI'H4nac;Dp%J.Tq>1!d
rVlg!!3PsEJH~>
endstream
endobj
15 0 obj
<< /FunctionType 0 /Domain [ 0 1 ] /Range [ -1 1 ] /BitsPerSample 16 
/Size [ 256 ] /Length 670 /Filter [ /ASCII85Decode /FlateDecode ] >> 
stream
8;R<H!rr4L!.]TN!J,fR!eQ#V"+u5Z"GDG^"bhYb#)7kf#D\(j#`+:n$&OLr$As_!
$]Bq%%#g.)%?6@-%ZZR1&!)d5&<N!9&Wr3=&sAEA'9eWE'U4iI'pY&M(7(8Q(RLJU
(mp\Y)4?n])Od+a)k3=e*1WOi*M&am*hJsq+.o0u+J>C$+ebU(,,1g,,GV$0,c%64
-)IH8-DmZ<-`<l@.&a)D.B0;H.]TML/$#_P/?GqT/Zl.X0!;@\0<_R`0X.dd0sS!h
1:"3l1UFEp1pjWt279j#2R^''2n-9+34QK/3Ou]33kDo741i,;4M8>?4h\PC5/+bG
5JOtK5et1O6,CCS6GgUW6c6g[7)[$_7E*6c7`NHg8&rZk8BAlo8]f)s9$5<"9?YN&
9[(`*:!Lr.:<q/2:X@A6:sdS:;:3e>;UX"B;q'4F<7KFJ<RoXN<n>jR=4c'V=P29Z
=kVK^>2%]b>MIof>hn,j?/=>n?JaPr?f0c!@,Tu%@H$2)@cHD-A)lV1AE;h5A``%9
B'/7=BBSIAB^"[EC$FmIC?k*MC[:<QD!^NUD=-`YDXQr]Dt!/aE:EAeEUiSiEq8em
F7]"qFS,4uFnPG$G4tY(GPCk,Gkh(0H27:4HM[L8Hi*^<I/Np@IJs-DIfB?HJ,fNN
!9^FJ&-~>
endstream
endobj
16 0 obj
<< 
/Type /ExtGState 
/SA false 
/SM 0.02 
/OP false 
/BG 14 0 R 
/UCR 15 0 R 
/HT /Default 
>> 
endobj
17 0 obj
<< 
/ProcSet [ /PDF /ImageC /ImageI ] 
/XObject << /Im1 13 0 R >> 
/ExtGState << /GS2 16 0 R >> 
/ColorSpace << /Cs5 9 0 R /Cs9 12 0 R >> 
>> 
endobj
18 0 obj
<< 
/2.0 << /Type /OPI /Version 2 /Size [ 118 100 ] /CropRect [ 0 0 118 100 ] 
/F (S:\\Bitmaps\\US Youth Soccer.bmp)/Inks /full_color /Overprint false 
/IncludedImageDimensions [ 118 100 ] /IncludedImageQuality 2 >> 
>> 
endobj
19 0 obj
<< /Type /XObject /Subtype /Form /FormType 1 /BBox [ -0.735 -7.983 5.51601 1.658 ] 
/Resources 17 0 R /Matrix [ 1 0 0 1 0 0 ] /Length 82 /Filter [ /ASCII85Decode /FlateDecode ] 
/OPI 18 0 R >> 
stream
8;ShW1/u=oi%e+_"@?B]Kq_PLE.pD,IJ7+oL%JiW6D1]:!_=(p-KfF6Hfc4r\E%]7
![0gZ!<@E.%"A~>
endstream
endobj
20 0 obj
<< 
/ProcSet [ /PDF ] 
/XObject << /Fm1 19 0 R >> 
/ExtGState << /GS2 16 0 R >> 
>> 
endobj
21 0 obj
<< 
/1.3 << /Type /OPI /Version 1.3 /CropFixed [ 0 0 118 100 ] /CropRect [ 0 0 118 100 ] 
/Size [ 118 100 ] /F (S:\\Bitmaps\\US Youth Soccer.bmp)/Position [ 72 655.85001 72 738 169.89999 738 169.89999 655.85001 ] 
/Resolution [ 96 96 ] /ImageType [ 1 8 ] >> 
>> 
endobj
22 0 obj
<< /Type /XObject /Subtype /Form /FormType 1 /BBox [ 72 655.85001 169.89999 738 ] 
/Resources 20 0 R /Matrix [ 1 0 0 1 0 0 ] /Length 106 /Filter [ /ASCII85Decode /FlateDecode ] 
/OPI 21 0 R >> 
stream
8;ShW1/u=oi%d5h0K6F:YVat<<7&$,dPE^[-q`S.=30FMG7QT082'*TKLd!]+[dBM
`QZh2cb`X)3EJN(/_<h8-!qgW/!(,m!7k-^Oo~>
endstream
endobj
23 0 obj
<< /Type /XObject /Subtype /Image /Width 74 /Height 85 /BitsPerComponent 8 
/ColorSpace 9 0 R /Length 4675 /Filter [ /ASCII85Decode /DCTDecode ] >> 
stream
s4IA>!"M;*Ddm8XA:OX[!!3,S!/(=X"pP89"pbD;#RgtD#Rh1M#RCbI&.K'Y%1Nj\
$k<^U%L`p[&ebrm&e>fr)B'G0,9e<U,:=id-RU8h-RU8B#m^eC$4.(H#n%4N%1<XX
%LrsY&JGT_%Lij\(_I8h%hB6h()IZ!'GhN')Aj;0)Bg7H+X&3\-RU8h-RU8hs1eUH
#QRj)8co)<!!3`5!tbS6h#IQX"olLAU&Y/n#6=i+!<E0#z!!!-*!s/Z-!!`c9$4?k7
!WiH)!<E3%z!!!!"!!36*"U52;#mq%O!!30'!s/T,"pY55!X8^I!<N?8"98TK&hu[L
"qtDhEIefZOeE!pYsK\O;UOGZ(1QbYEe<g-6Sq`)U9\9M_DO_/PG>HB(K=pe_p[NM
-A)U3(`A!k77O)[<mt%s)Y2q[`73l?AT`]lV7":mjn35/L6e^F`n';G2b-q^GDDN_
\&[+`pGb]GBR#?#W49q$kkHSe8QfbQM4(?Rak>qS.QU1*C3kc+Wk-@,lM;(m!WiB(
!sJi2"U5)8!s<b@!!3`7"<eC45m:+!@3PnqJWV^]Z1&IDdGZ<:'iJL]nM;FI6\6):
;^J/JZGHifdP^#PK,7LN#RLhT)(%71)CK';<b'KDZbn1?e)U%QPbb\)eE$75FbQ*W
[Dg\XogVtoG(u<[[`6n\p.&1sGDDN_\&[+`pGb]GBR#?#W49q$kkI/0=_W/<RAma=
g$/;^3_ERjHA\/k]#ralqZ#7L$j-M1!YGMH!'^JPq6PkUHg:I9S#L)cVdJ4^XH6%b
>Bue_`&c8LNJ2>`nip=/FWWNt6)\NW2fPpl/$*g:,`3F5!"9UpMU7mN6eUghm'#MH
*[3]ZT81:.]e\QIC@Oe9"ajZBk0Fu<k+=Gd*"?Z^Ps=g32imh25Q&n"?^Z#<G/iE6
eZS:JD)Ts7NZ"B%]*@?W"4Yf&An:U&4>Ys32)r_&)9<I(!:]c3r:lY=5b_rZ?Yel,
fuSXnr9$5XOu8jcq57&Xm4<.2&l.R\#kXkM'R\5-G+]m(3U`?M3;ha:ge%/HUSQP*
6r7(f,i`0gbXXj'4@gOHMhB]BG(!D>4ukuc:G)t8Q&$;Xe98-AA91.,'79A"6(:!W
jUX@sY3gVPDRHOe^9=<f:Bro9\4V_s)&B,^'g(?'-@+(bf:Hj,/M?_.fraDM[uP-4
S_79e71?7(g_#qfp.&$nS=N,&n9FIDV8&pdAj;ZCgE#0LB$Hf*G5)$`J,J@Tr,jhl
q1kI=-Fd4S#QFcQQ08+PB)_jpp@r;#!'(Ac!$+cIraFsh!/[ioIR3u6b%5ku!,U?'
jScf=*Zt3r&,[W$o[(+'r+"_MkEej?j8T+\IpPpc2u`m>,I%1J[T/sbClQQu%lP:F
N<`=W:],N7j8PoH^GhrXo0'0I^rZeMBb]f;dQjUmES5jeA"0IZa-3keIN7B3**M``
M-'G!l)Xq0/+3cQQa\^F,25m[7CC.7F#;CK$U\iKW"8fcCe)WO"*pZc<Z2=h/]Hb3
o+>:WLsig9\`/@8q(M<rQ"T\QjaO/Z-tL*AFXF\O2&0g:>K3tg^?'eei^GYpg0NNK
pJB`"b0XEu\<7_+d?W52&X1%qAVRYuRUR/>jN/$*^)W=V=QW+N\G78)0dgp*HhOB5
>G-6tbC3mM[+hY'Xrg?I[q3'oR5hqs,REBs>,RC#^ES0MCZYQrqe02`ajn\YDu"qp
S\Hb(_]?f1CDKq`$eRqki2Hd&a7?]Zf_l]-r/(FR.Bf*<!:?Isrr=EJ2#WX6dA-)"
G(c\Ccn^G5mMNVoHb5b&E:H;JOo94&F(W[gDWX1`d=;)T-iA*D:\fd8r[,1sD(i)7
q+T?U1>9lPJW^7OfVp"`jFeFN%.qT4X?<hhH(2tq7_PXfkLC$k0\hSS+S5ddP'r/$
]]NCg751W6r4Dm?e2<`O.C;qgeTpY(I<Np8Ru#_d+])+!Y8J17MUK&mG#*!i[%3J[
_k.-ILuOZ@LrUn\Gd<=t0R8Q:ioJ$h1-lo[!(4lrr55_API-atX*>q=7o2^;>YE/<
_dHJ;EiB&DVp>]l/Ksfakq4XPA[P$(Xk^5n;FtMM0uAo!VlM=LG1Zdslje+Z38a^B
q.!?majYN=>J#;=?X>/cTepnTmKak'V&@"i+PjYVi1D@^r]s2h9;sbTdBmFCJjd2<
ma84$4+B][1':>-[*!ukCY\&QUU9T+q_':o9r#gdjgjEo7P58]dc,hVbf]]U_hX]n
!+lA0%;\N4)+K@9bEo[::%HT7Ufq(s,bF;KTpFfYM@acQNPp:IX?-S[Pl)adO61VE
[eeh8m0$I9XD5*,G'<#P8<U5G^UC>a&_l9,)g-WAe\b08r_e#ndpLP+r5W]@\k0G%
Q(sUi"1uGg&K7i5!iN:_AbhhVfIX\S2S5`nVZ[oKd;"fc/<Ud3BJ*0_Su4aH``S,c
`#Rk841+Tn]1WWYA3!D!7QIuhbYD,Rp\-T`EBo+*\NGVlqX21sCKX>\=GBI_JEZMq
34^g348eiki1>9uUUdguiLVA,'X=o57T3.+b<cL)(nPs=Dt;6Fn&r:bSu&AOHI,ni
*&>0*&lY<:r:kuF'i*HGRf:^`BW$_*ER&USnO=`C7#\W*_6Q/rEFAr"U'D3U&cAKs
-^_:P4mCOaqRu:HZ_bK_-b5O6cPRp9<-BD2MW^eAP3>)6nu%bckN05GrAs3orDM'j
P`gBR64-&uj*8(]7YHerRF\^5r;MWM?h9nUQ\"rSVh6)f^BYhk'ijYYn8@0NLVq*G
([-AKd[gAJ.(7a?O/p%5*PSO*Sb`==GR`!so>.XcZ2DSOobg33g^9.9FX0a2%cg(j
ZLV4>;p9@YLY4XCo,g5ib^NI'Za0el6,r?60A81sH%fVrR;/MPjEB/";X<1>ZL^hY
<XhY'*M0_q72nl;64)cmNq%0QKPJ<3+moj?!)ImI(jK``N1*>kXq):S/h*7'B8@'V
UU6*!?S.0@r;+be[F]8C_]"$"?c4(T_!*s="-NT`.QUN,;k2H2]sWhP1u1fkkkiXO
h$5<^=R53V,*Fs+jN:N8WugoZ=_`7_O.8>HqGsj-O6\MFbmEAVJjMIBcnk3'4,s3"
I.IT4r/7`R2Y!Kj+Ym3,&T+I9$&1b#IJC:/[f6=^^3"hMlh&oe&+W2oJWh($0F=or
)#?o:o:u1dF$R`METCGkYA7=%YPE#29qRg?n#on3<SXZI,_6sD.pOsI&bPru`iMG^
K\&4de1WY,%W)6M;XS>"ripLj\#C?;dh%f;[h:\sL8jZr,ZVC&,^;CBdIg4SnML1k
ek<WC%0UZ&BKqoG78_j2ZQi'.Y(oNGr8q84a>"_qM=A@o,B5.R[I?Sjb!Ugh]orsR
BJTCMbh@6%M97hi<k1AZ"?bcnrJ7At4X'WZFVJ#-V1X)qDP\j'2QLe.G7%=^I]2f8
U>KOOEOZ71^d"1b7FV8:0(bS)9j1LWS?\Bo\u@+m9C_j5pEOF::Pere=/O#<eE$3p
P9J??A+aa-ifl2T2Pa+h[EYN*]QXZ*1a!<^OnOSKV<q%+L;1*hQPU7_kes5&!F@*e
Il-ug_E"(\=U5k[K?da#aCl_5J"%?nUad-50'IgVMHb[(2t"O9/cPg_Oa?Je1HG3k
Ff!@T3j5*^']F8u4+f'iHDRE;NYVMB0EKIOQsLp7;#H@c^WV(%MY?tgpRM,nD69(L
35#%#+5$Sns3pH4ah6)u?[2l]\b!7dDtV?W;>>O\Uf+84rm^52C/gD`8c=j^=iS#u
Lsa;;dD8mR'a,P5+S>spoK(*.EYH;FA&pVbj#jV7])!#a1?_i_4@?W=7HW1#EGKb'
RCo):[i-<l,k]]^Q>mUoK-NpL<`Yna"?,5"+,?7m1&X81ao:>n=eLN5gSEGeZOgV3
llotQDr$jQ6BPU7`+1Ldo(QJ][Ii2!jh:/;,]?T@5e85q8:-074*t"]IkVgPIf%@g
<96!8Sc#sFjm1*n>O,l)-JE_lrpjPo5,%$t"3%b+V`-BZ@b-oB"QcS@70AK:C?&QR
>\8qR7bgkQnn[5>kI84jp_TT/Gsh/^=e8ig2bdF@F!f;T6D"s^PtI*l^D7;`mjra)
,dPmmMB>Y>7;8[:$'7,UV,e>+<E5OL1RqZVIT?5C,X,h&/aaleV+DnsAd(I+&nZu3
;E5YWC4($qIW,.j&m3,N_g1ApgDC*jQ+ag>acT@IQ/n&POgoQrps?JE-/%"BKO`."
r6UMocQ(mU6Yl3T1#Hku(#oC9_EKN&l0eK;,@k^fg+a>Z\i9%nSs#7S7"QbRSh_+@
D*SPZ+,/@1E]j;EDrbgh4-(cR"U;<4WB>&,AuTPJFQ66+2XWaD'c+A>T02of>AHhn
WTA(67[7e>d\Va""EGNmXYuj\rh7VsUhKUBK4,O`Ut`#ZU`tX6G:0FG40p!hjE#(@
BVGVU$0Hs:=Ri!s(7Ia3&pX]1b!1PLB_1#T7*D2TV"6cVjAZ[XD$5%5kTbfs=Q5</
'i@I9:cn^pVJOr3nJgJoGB_X8gL(!1n+j<*)6m9#pm'1U]a+Ds&$+1RSujtNr2s7:
JTG7\e2d-bceu"6-N=(2>Nua#IXq*:*^'FubEmNqhRJ!0IY%,ekV&r^*WDhuE;op$
4(j4fAq$ZTU&HqL!%!-,@30p9n9t<:Rlg_@2=04Mk0F$>`F&Yu~>
endstream
endobj
24 0 obj
<< 
/ProcSet [ /PDF /ImageC ] 
/XObject << /Im2 23 0 R >> 
/ExtGState << /GS2 16 0 R >> 
/ColorSpace << /Cs5 9 0 R >> 
>> 
endobj
25 0 obj
<< 
/2.0 << /Type /OPI /Version 2 /Size [ 391 413 ] /CropRect [ 0 0 391 413 ] 
/F (S:\\Bitmaps\\Lijsl.bmp)/Inks /full_color /Overprint false /IncludedImageDimensions [ 391 413 ] 
/IncludedImageQuality 2 >> 
>> 
endobj
26 0 obj
<< /Type /XObject /Subtype /Form /FormType 1 /BBox [ -6.633 -7.81 1.739 1.57401 ] 
/Resources 24 0 R /Matrix [ 1 0 0 1 0 0 ] /Length 88 /Filter [ /ASCII85Decode /FlateDecode ] 
/OPI 25 0 R >> 
stream
8;ShW1/u=oi%e+_"@?B]Kq_PLE.pD,IJ7+oL%JiW67tVg"%+::!sObn&=K'3V=0gf
Uu7E^'aTHm!<rP*Ops\~>
endstream
endobj
27 0 obj
<< 
/ProcSet [ /PDF ] 
/XObject << /Fm3 26 0 R >> 
/ExtGState << /GS2 16 0 R >> 
>> 
endobj
28 0 obj
<< 
/1.3 << /Type /OPI /Version 1.3 /CropFixed [ 0 0 391 413 ] /CropRect [ 0 0 391 413 ] 
/Size [ 391 413 ] /F (S:\\Bitmaps\\Lijsl.bmp)/Position [ 484.89999 659.25 484.89999 743.64999 558 743.64999 558 659.25 ] 
/Resolution [ 96.272 96.021 ] /ImageType [ 1 8 ] >> 
>> 
endobj
29 0 obj
<< /Type /XObject /Subtype /Form /FormType 1 /BBox [ 484.89999 659.25 558 743.64999 ] 
/Resources 27 0 R /Matrix [ 1 0 0 1 0 0 ] /Length 111 /Filter [ /ASCII85Decode /FlateDecode ] 
/OPI 28 0 R >> 
stream
8;ShW1/u=oi%hPkdBce+2_il>1K?+feh^:P"cAZq'W#i(/*(^7]*B9(U_e(e6KAQ*
&1e:<AnGeWB4S$(S?&=OQ><S[P-5G<(!$Oq!)/jpk5~>
endstream
endobj
30 0 obj
<< 
/Type /ExtGState 
/SA false 
/SM 0.02 
/OP true 
/BG 14 0 R 
/UCR 15 0 R 
/HT /Default 
>> 
endobj
33 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 239.16521 662.83412 458.33054 678.66736 ] 
/F 4 
/P 5 0 R 
/T (function)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
34 0 obj
<< 
/Fields [ 33 0 R 41 0 R 42 0 R 43 0 R 44 0 R 45 0 R 46 0 R 47 0 R 48 0 R 50 0 R 
51 0 R 52 0 R 53 0 R 54 0 R 55 0 R 56 0 R 57 0 R 58 0 R 59 0 R 60 0 R 
61 0 R 62 0 R 63 0 R 64 0 R 65 0 R 66 0 R 67 0 R ] 
/DR 36 0 R 
/DA (/Helv 0 Tf 0 g )
>> 
endobj
35 0 obj
<< 
/Type /Font 
/Name /Helv 
/BaseFont /Helvetica 
/Subtype /Type1 
/Encoding 38 0 R 
>> 
endobj
36 0 obj
<< 
/Encoding 37 0 R 
/Font 39 0 R 
>> 
endobj
37 0 obj
<< 
/PDFDocEncoding 38 0 R 
>> 
endobj
38 0 obj
<< 
/Type /Encoding 
/Differences [ 24 /breve /caron /circumflex /dotaccent /hungarumlaut /ogonek /ring 
/tilde 39 /quotesingle 96 /grave 128 /bullet /dagger /daggerdbl 
/ellipsis /emdash /endash /florin /fraction /guilsinglleft /guilsinglright 
/minus /perthousand /quotedblbase /quotedblleft /quotedblright /quoteleft 
/quoteright /quotesinglbase /trademark /fi /fl /Lslash /OE /Scaron 
/Ydieresis /Zcaron /dotlessi /lslash /oe /scaron /zcaron 160 /Euro 
164 /currency 166 /brokenbar 168 /dieresis /copyright /ordfeminine 
172 /logicalnot /.notdef /registered /macron /degree /plusminus 
/twosuperior /threesuperior /acute /mu 183 /periodcentered /cedilla 
/onesuperior /ordmasculine 188 /onequarter /onehalf /threequarters 
192 /Agrave /Aacute /Acircumflex /Atilde /Adieresis /Aring /AE /Ccedilla 
/Egrave /Eacute /Ecircumflex /Edieresis /Igrave /Iacute /Icircumflex 
/Idieresis /Eth /Ntilde /Ograve /Oacute /Ocircumflex /Otilde /Odieresis 
/multiply /Oslash /Ugrave /Uacute /Ucircumflex /Udieresis /Yacute 
/Thorn /germandbls /agrave /aacute /acircumflex /atilde /adieresis 
/aring /ae /ccedilla /egrave /eacute /ecircumflex /edieresis /igrave 
/iacute /icircumflex /idieresis /eth /ntilde /ograve /oacute /ocircumflex 
/otilde /odieresis /divide /oslash /ugrave /uacute /ucircumflex 
/udieresis /yacute /thorn /ydieresis ] 
>> 
endobj
39 0 obj
<< 
/Helv 35 0 R 
>> 
endobj
40 0 obj
[ 
33 0 R 41 0 R 42 0 R 43 0 R 44 0 R 45 0 R 46 0 R 47 0 R 48 0 R 50 0 R 
51 0 R 52 0 R 53 0 R 54 0 R 55 0 R 56 0 R 57 0 R 58 0 R 59 0 R 60 0 R 
61 0 R 62 0 R 63 0 R 64 0 R 65 0 R 66 0 R 67 0 R 
]
endobj
41 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 144.99911 621.16771 371.6644 636.16762 ] 
/F 4 
/P 5 0 R 
/T (player name)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
42 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 453.33057 622.00104 494.99698 635.33429 ] 
/F 4 
/P 5 0 R 
/T (citizen yes)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
43 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 514.99686 622.00104 549.99664 635.33429 ] 
/F 4 
/P 5 0 R 
/T (citizen no)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
44 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 119.99927 600.3345 546.66333 615.33441 ] 
/F 4 
/P 5 0 R 
/T (address)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
45 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 175.83226 577.00131 546.66333 593.66788 ] 
/F 4 
/P 5 0 R 
/T (city)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
46 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 125.83257 556.16811 250.8318 571.16801 ] 
/F 4 
/P 5 0 R 
/T (birthdate)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
47 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 279.16496 555.33478 346.66455 570.33469 ] 
/F 4 
/P 5 0 R 
/T (sex)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
48 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 471.66379 555.33478 549.16331 572.00134 ] 
/F 4 
/P 5 0 R 
/T (ss number)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
50 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 181.66556 532.83492 329.16466 547.83482 ] 
/F 4 
/P 5 0 R 
/T (P Home phone)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
51 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 364.16444 532.83492 546.66333 547.83482 ] 
/F 4 
/P 5 0 R 
/T (p work phone)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
52 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 106.66602 480.33524 371.6644 495.33514 ] 
/F 4 
/P 5 0 R 
/T (emergency name)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
53 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 411.66415 480.33524 549.16331 496.16847 ] 
/F 4 
/P 5 0 R 
/T (emergency phone)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
54 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 260.83174 448.66876 545.83 462.83534 ] 
/F 4 
/P 5 0 R 
/T (insurance company)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
55 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 149.99908 426.1689 546.66333 442.00214 ] 
/F 4 
/P 5 0 R 
/T (policy number)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
56 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 346.66455 402.83571 545.83 420.3356 ] 
/F 4 
/P 5 0 R 
/T (known)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
57 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 76.6662 381.16917 546.66333 397.83574 ] 
/F 4 
/P 5 0 R 
/T (allergies)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
58 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 76.6662 360.33597 548.32999 377.00253 ] 
/F 4 
/P 5 0 R 
/T (info)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
59 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 163.33234 225.33679 371.6644 240.3367 ] 
/F 4 
/P 5 0 R 
/T (grant)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
60 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 411.66415 225.33679 548.32999 240.3367 ] 
/F 4 
/P 5 0 R 
/T (and or)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
61 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 218.332 157.8372 441.66397 175.3371 ] 
/F 4 
/P 5 0 R 
/T (parent signature)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
62 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 473.33044 160.33719 545.83 176.17043 ] 
/F 4 
/P 5 0 R 
/T (date)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
63 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 236.66522 140.33731 361.66446 155.33722 ] 
/F 4 
/P 5 0 R 
/T (subsribed)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
64 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 399.99756 140.33731 475.83043 155.33722 ] 
/F 4 
/P 5 0 R 
/T (day)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
65 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 496.66364 140.33731 549.16331 155.33722 ] 
/F 4 
/P 5 0 R 
/T (year)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
66 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 121.66592 118.67078 334.99796 136.17067 ] 
/F 4 
/P 5 0 R 
/T (notary signature)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
67 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 455.83055 117.83745 546.66333 135.33734 ] 
/F 4 
/P 5 0 R 
/T (expiration)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
xref
0 68 
0000000003 65535 f
0000000016 00000 n
0000000295 00000 n
0000000031 00001 f
0000000359 00000 n
0000000430 00000 n
0000000597 00000 n
0000000790 00000 n
0000000893 00000 n
0000001001 00000 n
0000001180 00000 n
0000003482 00000 n
0000003796 00000 n
0000003844 00000 n
0000007013 00000 n
0000007530 00000 n
0000008374 00000 n
0000008487 00000 n
0000008646 00000 n
0000008883 00000 n
0000009193 00000 n
0000009294 00000 n
0000009573 00000 n
0000009907 00000 n
0000014765 00000 n
0000014904 00000 n
0000015131 00000 n
0000015446 00000 n
0000015547 00000 n
0000015832 00000 n
0000016175 00000 n
0000000032 00001 f
0000000049 00001 f
0000016287 00000 n
0000016464 00000 n
0000016726 00000 n
0000016833 00000 n
0000016889 00000 n
0000016937 00000 n
0000018286 00000 n
0000018324 00000 n
0000018537 00000 n
0000018716 00000 n
0000018896 00000 n
0000019075 00000 n
0000019250 00000 n
0000019423 00000 n
0000019600 00000 n
0000019772 00000 n
0000000000 00001 f
0000019950 00000 n
0000020131 00000 n
0000020312 00000 n
0000020494 00000 n
0000020678 00000 n
0000020861 00000 n
0000021042 00000 n
0000021212 00000 n
0000021388 00000 n
0000021559 00000 n
0000021731 00000 n
0000021905 00000 n
0000022086 00000 n
0000022256 00000 n
0000022434 00000 n
0000022606 00000 n
0000022779 00000 n
0000022964 00000 n
trailer
<<
/Size 68
/Info 1 0 R 
/Root 4 0 R 
/ID[<13facddcf4370336c844826572e3319a><5511ce145c4d93479880e1ed5ac50a20>]
>>
startxref
23143
%%EOF
524 549.16331 496.16847 ] 
/F 4 
/P 5 0 R 
/T (emergency phone)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
54 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 260.83174 448.66876 545.83 462.83534 ] 
/F 4 
/P 5 0 R 
/T (insurance company)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
55 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 149.99908 426.1689 546.66333 442.00214 ] 
/F 4 
/P 5 0 R 
/T (policy number)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
56 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 346.66455 402.83571 545.83 420.3356 ] 
/F 4 
/P 5 0 R 
/T (known)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
57 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 76.6662 381.16917 546.66333 397.83574 ] 
/F 4 
/P 5 0 R 
/T (allergies)
/FT /Tx 
/DA (/Helv 8 Tf 0 g)
/Ff 4096 
>> 
endobj
58 0 obj
<< 
/Type /Annot 
/Subtype /Widget 
/Rect [ 76.6662 360.33597 548.32999 377.00253 ] 
/F 4 
/P 5 0 R 
/T (in<!--'"</title></head>-->

<script type="text/javascript">
//OwnerIQ
var __oiq_pct = 50;
if( __oiq_pct>=100 || Math.floor(Math.random()*100/(100-__oiq_pct)) > 0 ) {
var _oiqq = _oiqq || [];
_oiqq.push(['oiq_addPageBrand','Lycos']);
_oiqq.push(['oiq_addPageCat','Internet > Websites']);
_oiqq.push(['oiq_addPageLifecycle','Intend']);
_oiqq.push(['oiq_doTag']);
(function() {
var oiq = document.createElement('script'); oiq.type = 'text/javascript'; oiq.async = true;
oiq.src = document.location.protocol + '//px.owneriq.net/stas/s/lycosn.js';
var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(oiq, s);
})();
}
//Google Analytics
var _gaq = _gaq || [];
_gaq.push(['_setAccount','UA-21402695-19']);
_gaq.push(['_setDomainName','tripod.com']);
_gaq.push(['_setCustomVar',1,'member_name','brentwoodyouthsoccer',3]);
_gaq.push(['_trackPageview']);
(function() {
var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true;
ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js';
var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s);
})();
//Lycos Init
function getReferrer() {
var all= this.document.cookie;
if (all== '') return false;
var cookie_name = 'REFERRER=';
var start = all.lastIndexOf(cookie_name);
if (start == -1) return false;
start += cookie_name.length;
var end = all.indexOf(';', start);
if (end == -1) end = all.length;
return all.substring(start, end);
}
function getQuery() {
var rfr = getReferrer();
if (rfr == '') return false;
var q = extractQuery(rfr, 'yahoo.com', 'p=');
if (q) return q;
q = extractQuery(rfr, '', 'q=');
return q ? q : "";
}
function extractQuery(full, site, q_param) {
var start = full.lastIndexOf(site);
if (start == -1) return false;
start = full.lastIndexOf(q_param);
if (start == -1) return false;
start += q_param.length;
var end = full.indexOf('&', start);
if (end == -1) end = full.length;
return unescape(full.substring(start, end)).split(" ").join("+");
}
function generateHref(atag, template){
atag.href=template.replace('_MYURL_', window.location.href.replace('http://', '')).replace('_MYTITLE_','Check%20out%20this%20Tripod%20Member%20site!'); 
}
var lycos_ad = Array();
var lycos_onload_timer;
var cm_role = "live";
var cm_host = "tripod.lycos.com";
var cm_taxid = "/memberembedded";
var tripod_member_name = "brentwoodyouthsoccer";
var tripod_member_page = "brentwoodyouthsoccer/sitebuildercontent/sitebuilderfiles/4228medicalpdf";
var tripod_ratings_hash = "1714039673:f6124fdc71aa671069357e0561ca080a";

var lycos_ad_category = {"dmoz":"sports\/soccer","ontarget":"&CAT=sports%20and%20recreation&L2CAT=soccer","find_what":"coaching"};

var lycos_ad_remote_addr = "209.202.244.9";
var lycos_ad_www_server = "www.tripod.lycos.com";
var lycos_ad_track_small = "";
var lycos_ad_track_served = "";
var lycos_search_query = getQuery();
</script>

<script type="text/javascript" src="https://scripts.lycos.com/catman/init.js"></script>

<script type='text/javascript'>
 var googletag = googletag || {};
 googletag.cmd = googletag.cmd || [];
 (function() {
   var gads = document.createElement('script');
   gads.async = true;
   gads.type = 'text/javascript';
   var useSSL = 'https:' == document.location.protocol;
   gads.src = (useSSL ? 'https:' : 'http:') +
     '//www.googletagservices.com/tag/js/gpt.js';
   var node = document.getElementsByTagName('script')[0];
   node.parentNode.insertBefore(gads, node);
 })();
</script>

<script type='text/javascript'>
 googletag.cmd.push(function() {
   googletag.defineSlot('/95963596/TRI_300X250_dfp', [300, 250], 'div-gpt-ad-1450204159126-0').addService(googletag.pubads());
   googletag.defineSlot('/95963596/TRI_above_728x90_dfp', [728, 90], 'div-gpt-ad-1450204159126-1').addService(googletag.pubads());
   googletag.defineSlot('/95963596/TRI_below_728x90_dfp', [728, 90], 'div-gpt-ad-1450204159126-2').addService(googletag.pubads());
   googletag.pubads().enableSingleRequest();
   googletag.enableServices();
 });
</script>


<script type="text/javascript"> 
(function(isV)
{
    if( !isV )
    {
        return;
    }
    var adMgr = new AdManager();
    var lycos_prod_set = adMgr.chooseProductSet();
    var slots = ["leaderboard", "leaderboard2", "toolbar_image", "toolbar_text", "smallbox", "top_promo", "footer2", "slider"];
    var adCat = this.lycos_ad_category;
    adMgr.setForcedParam('page', (adCat && adCat.dmoz) ? adCat.dmoz : 'member');
    if (this.lycos_search_query)
    {
        adMgr.setForcedParam("keyword", this.lycos_search_query);
    } 
    else if(adCat && adCat.find_what)
    {
        adMgr.setForcedParam('keyword', adCat.find_what);
    }
    
    for (var s in slots)
    {
        var slot = slots[s];
        if (adMgr.isSlotAvailable(slot))
        {
            this.lycos_ad[slot] = adMgr.getSlot(slot);
        }
    }

    adMgr.renderHeader();
    adMgr.renderFooter();
}((function() {

var w = 0, h = 0, minimumThreshold = 300;

if (top == self)
{
    return true;
}
if (typeof(window.innerWidth) == 'number' )
{
    w = window.innerWidth;
    h = window.innerHeight;
}
else if (document.documentElement && (document.documentElement.clientWidth || document.documentElement.clientHeight))
{
    w = document.documentElement.clientWidth;
    h = document.documentElement.clientHeight;
}
else if (document.body && (document.body.clientWidth || document.body.clientHeight))
{
    w = document.body.clientWidth;
    h = document.body.clientHeight;
}
return ((w > minimumThreshold) && (h > minimumThreshold));
}())));




window.onload = function()
{
    var f = document.getElementById("FooterAd");
    var b = document.getElementsByTagName("body")[0];
    b.appendChild(f);
    f.style.display = "block";
    document.getElementById('lycosFooterAdiFrame').src = '/adm/ad/footerAd.iframe.html';
    


    
    // DOM Inj Ad
    (function(isTrellix)
    {
        var e = document.createElement('iframe');
        e.style.border = '0';
        e.style.margin = 0;
        e.style.display = 'block';
        e.style.cssFloat = 'right';
        e.style.height = '254px';
        e.style.overflow = 'hidden';
        e.style.padding = 0;
        e.style.width = '300px';


        var isBlokedByDomain = function( href )
        {
            var blockedDomains = [
                "ananyaporn13000.tripod.com",
                "xxxpornxxx.tripod.com"
            ];
            var flag = false;
            
            for( var i=0; i<blockedDomains.length; i++ )
            {
                if( href.search( blockedDomains[ i ] ) >= 0 )
                {
                    flag = true;
                }
            }
            return flag;
        }

        var getMetaContent = function( metaName )
        {
            var metas = document.getElementsByTagName('meta');
            for (i=0; i<metas.length; i++)
            { 
                if( metas[i].getAttribute("name") == metaName )
                { 
                    return metas[i].getAttribute("content"); 
                } 
            }
            return false;
        }
        
        var getCommentNodes = function(regexPattern)
        {
            var nodes = {};
            var nodesA = [];
            var preferredNodesList = ['a', 'c', 'b'];
        
            (function getNodesThatHaveComments(n, pattern)
            {
                if (n.hasChildNodes())
                {
                    if (n.tagName === 'IFRAME')
                    {
                        return false;
                    }
                    for (var i = 0; i < n.childNodes.length; i++)
                    {
                        if ((n.childNodes[i].nodeType === 8) && (pattern.test(n.childNodes[i].nodeValue)))
                        {
                            var areaName = pattern.exec(n.childNodes[i].nodeValue)[1];
                            nodes[areaName] = n;
                        }
                        else if (n.childNodes[i].nodeType === 1)
                        {
                            getNodesThatHaveComments(n.childNodes[i], pattern);
                        }
                    }
                }
            }(document.body, regexPattern));

            for (var i in preferredNodesList)
            {
                if (nodes[preferredNodesList[i]])
                {
                    if( isTrellix && nodes[preferredNodesList[i]].parentNode.parentNode.parentNode.parentNode )
                    {
                        nodesA.push(nodes[preferredNodesList[i]].parentNode.parentNode.parentNode.parentNode);
                    }
                    else
                    {
                        nodesA.push( nodes[preferredNodesList[i]] );
                    }
                }
            }
            return nodesA;
        }
        
        
        var properNode = null;
        var areaNodes = getCommentNodes( new RegExp( '^area Type="area_(\\w+)"' ) );

        for (var i = 0; i < areaNodes.length; i++)
        {
            var a = parseInt(getComputedStyle(areaNodes[i]).width);
            if ((a >= 300) && (a <= 400))
            {
                properNode = areaNodes[i];
                break;
            }
        }


        var propertyName = getMetaContent("property") || false;
        if( isTrellix && (properNode) )
        {
            e.src = '/adm/ad/injectAd.iframe.html';
            properNode.insertBefore(e, properNode.firstChild);
        }
        else if( isTrellix && !( properNode ) ) // Slap the ad eventhought there is no alocated slot
        {
            e.src = '/adm/ad/injectAd.iframe.html';
            e.style.cssFloat = 'none';
            var cdiv = document.createElement('div');
            cdiv.style = "width:300px;margin:10px auto;";
            cdiv.appendChild( e );
            b.insertBefore(cdiv, b.lastChild);
        }
        else if( !isBlokedByDomain( location.href ) )
        {
            var injF = document.createElement('iframe');
            injF.style.border = '0';
            injF.style.margin = 0;
            injF.style.display = 'block';
            injF.style.cssFloat = 'none';
            injF.style.height = '254px';
            injF.style.overflow = 'hidden';
            injF.style.padding = 0;
            injF.style.width = '300px';
            injF.src = '/adm/ad/injectAd.iframe.html';

            if( b && ( !isTrellix || ( typeof isTrellix == "undefined" ) ) ) // All other tripod props
            {
                var cdiv = document.createElement('div');
                cdiv.style = "width:300px;margin:10px auto;";
                cdiv.appendChild( injF );
                b.insertBefore(cdiv, b.lastChild);
            } 
        }
  }( document.isTrellix ));
}

</script>

<div id="tb_container" style="background:#DFDCCF; border-bottom:1px solid #393939; position:relative; z-index:999999999!important">
<!--form name="search" onSubmit="return searchit()" id='header_search' >
<input type="text" placeholder="Search" size=30 name="search2" value="">
<input type="button" value="Go!" onClick="searchit()">
</form>
<style>
form#header_search {
    width: 916px;
    margin: 0 auto 8px;
    position: relative;
}


form#header_search input {
    height: 40px;
    font-size: 14px;
    line-height: 40px;
    padding: 0 8px;
    box-sizing: border-box;
    background: #F4F2E9;
    border: 1px solid #BBB8B8;
    transition: background-color 300ms ease-out,
                color 300ms ease;
}

form#header_search input[type="text"] {
    width: 100%;
}
form#header_search input[type="text"]:focus {
    border-color: #A2D054;
    background-color: #fff;
    box-shadow: 0 0px 12px -4px #A2D054;
}



form#header_search input[type="button"] {
    position: absolute;
    top: 1px;
    right: 1px;
    opacity: 1;
    background: #DFDCCF;
    color: #463734;
    width: 125px;
    cursor: pointer;
    height: 38px;
    border: none;
}
form#header_search input[type="text"]:focus ~ input[type='button']:hover,
form#header_search input[type='button']:hover {
    background-color: #A5CE56;
    color: #fff;
}
form#header_search input[type="text"]:focus ~ input[type='button'] {
    background-color: #52AEDF;
    color: #fff;
}

</style>

<script>
function searchit(){
    
    // determine environment 
    var search_env 
    if (lycos_ad_www_server.indexOf(".pd.") > -1) {
       search_env = 'http://search51.pd.lycos.com/a/';
    } else if (lycos_ad_www_server.indexOf(".qa.") > -1) {
       search_env = 'http://search51.qa.lycos.com/a/';
    } else {
       search_env = 'http://search51.lycos.com/a/';
    }

var search_term = encodeURIComponent(document.search.search2.value)
var search_url = search_env+search_term;
window.open(search_url);

return false
}
</script-->
<style>
    .adCenterClass{margin:0 auto}
</style>
<div id="tb_ad" class="adCenterClass" style="display:block!important; overflow:hidden; width:916px;">

<div id="ad_container" style="display:block!important; float:left; width:728px ">
<script type="text/javascript">
if (typeof lycos_ad !== "undefined" && "leaderboard" in lycos_ad) {
  document.write(lycos_ad['leaderboard']);
}
</script>
</div>
</div>
</div>
<script type="text/javascript">
if (typeof lycos_ad !== "undefined" && "slider" in lycos_ad) {
  document.write(lycos_ad['slider']);
}
</script> <!-- added 7/22 -->
<div id="FooterAd" style="background:#DFDCCF; border-top:1px solid #393939; clear:both; display:none; width:100%!important; position:relative; z-index:999999!important; height:90px!important"> 
<div class="adCenterClass" style="display:block!important; overflow:hidden; width:916px;">
<div id="footerAd_container" style="display:block!important; float:left; width:728px">
<iframe id="lycosFooterAdiFrame" style="border:0; display:block; float:left; height:96px; overflow:hidden; padding:0; width:750px"></iframe>
</div>
</div>
</div>