Medical Certificate (To be completed by a medical doctor) by CraigGreenhill

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									   Medical Certificate (To be completed by a medical doctor)


The Irish Dance student (name)                                               suffers from/has the condition
                                              .


He/She has explained to me in detail what the Irish Dance classes entail. I am satisfied that this medical
condition does not put the student at risk.


Signature of Doctor:                                                                Date:
Address:


Phone Number:




Office Use Only
Medical Cert received:         /       /             Approved:     Yes    No

								
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