WI_MemberParentSignature?11|~~~~~~~~~~~~~~~~~Member/Parent Signature form~~~~~~~
WI_MemberParentSignature?11|Edit101~2~~12~1~137~97~200~~~~Edit Location: [X = 137]  [Y = 97]  DB Link: County~0~County~0~0~~~~0~~1~~~
WI_MemberParentSignature?11|Edit102~2~~12~1~490~97~200~~~~Edit Location: [X = 490]  [Y = 97]  DB Link: Primary Club~30~Primary Club~31~31~~~~0~~1~~~
WI_MemberParentSignature?11|Edit103~2~~12~1~137~130~220~~~~Edit Location: [X = 137]  [Y = 130]  DB Link: Last~1~Last~1~1~~~~0~~1~~~
WI_MemberParentSignature?11|Edit104~2~~12~1~490~130~220~~~~Edit Location: [X = 490]  [Y = 130]  DB Link: First~2~First~2~2~~~~0~~1~~~
WI_MemberParentSignature?11|Edit105~2~~12~0~137~158~250~~~~Edit Location: [X = 137]  [Y = 158]  DB Link: Street~4~Street~4~4~~~~0~~1~~~
WI_MemberParentSignature?11|Edit106~2~~12~0~490~158~200~~~~Edit Location: [X = 490]  [Y = 158]  DB Link: Phone~8~Phone~8~8~~~~0~~1~~~
WI_MemberParentSignature?11|Edit107~2~~12~0~137~186~200~~~~Edit Location: [X = 137]  [Y = 186]  DB Link: City~5~City~5~5~~~~0~~1~~~
WI_MemberParentSignature?11|Edit108~2~~12~0~437~186~50~~~~Edit Location: [X = 437]  [Y = 186]  DB Link: State~6~State~6~6~~~~0~~1~~~
WI_MemberParentSignature?11|Edit109~2~~12~0~518~186~140~~~~Edit Location: [X = 518]  [Y = 186]  DB Link: Zip~7~Zip~7~7~~~~0~~1~~~
WI_MemberParentSignature?11|Edit110~2~~12~0~137~216~300~~~~Edit Location: [X = 137]  [Y = 216]  DB Link: Email~23~Email~24~24~~~~0~~1~~~
WI_MemberParentSignature?11|Edit111~2~~12~1~137~65~200~~~~Edit Location: [X = 137]  [Y = 65]  DB Link: User Id~31~User Id~32~32~~~~0~~1~~~
WI_MemberParentSignature?11|Edit112~2~~12~0~41~299~45~~~~Edit Location: [X = 41]  [Y = 299]  DB Link: SF 1~43~SF 1~44~44~~~~0~~1~~~
WI_MemberParentSignature?11|Edit113~2~~12~0~38~389~45~~~~Edit Location: [X = 38]  [Y = 389]  DB Link: SF 2~44~SF 2~45~45~~~~0~~1~~~
WI_MemberParentSignature?11|Edit114~2~~12~0~35~526~45~~~~Edit Location: [X = 35]  [Y = 526]  DB Link: SF 3~45~SF 3~46~46~~~~0~~1~~~
WI_MemberParentSignature?11|Edit115~2~~12~0~490~64~200~~~~Edit Location: [X = 490]  [Y = 64]  DB Link: Password~32~Password~33~33~~~~0~~1~~~
WI_MemberParentSignature?11|Label101~1~County~12~0~74~100~0~~~~Label Location: [X = 74]  [Y = 100]~~~~~~~~~~1~~~
WI_MemberParentSignature?11|Label102~1~Primary Club~12~0~386~100~0~~~~Label Location: [X = 386]  [Y = 100]~~~~~~~~~~1~~~
WI_MemberParentSignature?11|Label103~1~Last Name~12~0~47~136~0~~~~Label Location: [X = 47]  [Y = 136]~~~~~~~~~~1~~~
WI_MemberParentSignature?11|Label104~1~First Name~12~0~399~136~0~~~~Label Location: [X = 399]  [Y = 136]~~~~~~~~~~1~~~
WI_MemberParentSignature?11|Label105~1~Address~12~0~62~165~0~~~~Label Location: [X = 62]  [Y = 165]~~~~~~~~~~1~~~
WI_MemberParentSignature?11|Label106~1~Phone~12~0~430~165~0~~~~Label Location: [X = 430]  [Y = 165]~~~~~~~~~~1~~~
WI_MemberParentSignature?11|Label107~1~City~12~0~93~194~0~~~~Label Location: [X = 93]  [Y = 194]~~~~~~~~~~1~~~
WI_MemberParentSignature?11|Label108~1~State~12~0~389~194~0~~~~Label Location: [X = 389]  [Y = 194]~~~~~~~~~~1~~~
WI_MemberParentSignature?11|Label109~1~Zip~12~0~490~194~0~~~~Label Location: [X = 490]  [Y = 194]~~~~~~~~~~1~~~
WI_MemberParentSignature?11|Label110~1~E-mail~12~0~79~223~0~~~~Label Location: [X = 79]  [Y = 223]~~~~~~~~~~1~~~
WI_MemberParentSignature?11|Label111~1~Member ID~12~0~47~72~0~~~~Label Location: [X = 47]  [Y = 72]~~~~~~~~~~1~~~
WI_MemberParentSignature?11|Label112~1~Web Password~12~0~369~66~0~~~~Label Location: [X = 369]  [Y = 66]~~~~~~~~~~1~~~
WI_MemberParentSignature?11|Label113~1~Print, sign, and return this page to your club or county leader.~12~5~190~14~0~~~~Label Location: [X = 190]  [Y = 14]~~~~~~~~~~1~~~
WI_MemberParentSignature?11|Memo101~3~~16~0~100~300~720~75~I want the University of Wisconsin-Extension to keep my name and contact [@&@]information private when creating a public record or list. [@&@]~~Text Location: [X = 100]  [Y = 300]~~~~~~~0~~~1~~~
WI_MemberParentSignature?11|Memo103~3~~16~0~100~384~715~130~I grant the University of Wisconsin Board of Regents and University of [@&@]Wisconsin-Extension (hereinafter University) the right to publish, and copyright [@&@]my image (including audio, moving image or photography) for educational  [@&@]programs, websites, and promotion of University programs. [@&@]~~Text Location: [X = 100]  [Y = 384]~~~~~~~0~~~1~~~
WI_MemberParentSignature?11|Memo104~3~~16~0~100~521~720~50~I require an accommodation for a disability to participate in this program. [@&@]~~Text Location: [X = 100]  [Y = 521]~~~~~~~0~~~1~~~
WI_MemberParentSignature?11|Memo105~3~~16~0~40~631~750~200~Member Signature  ___________________________________ Date  ________[@&@] [@&@][@&@]Parent/Guardian Signature  ____________________________  Date  ________[@&@][@&@][@&@]Leader Signature  ____________________________________  Date  ________[@&@]~~Text Location: [X = 40]  [Y = 631]~~~~~~~0~~~1~~~