%PDF-1.4
%
1 0 obj
<>stream
FREE PDFill PDF and Image Writer
Adobe Acrobat 10.0.02012-02-01T14:12:27-06:00
med_release_form_08_2.pdfNicholas
endstream
endobj
2 0 obj
<>/Type/Catalog/Metadata 1 0 R/Pages 4 0 R>>
endobj
5 0 obj
<>
endobj
4 0 obj
<>
endobj
3 0 obj
[0<
> 1<>]
endobj
6 0 obj
<>/TrimBox[0 0 612 792]/MediaBox[0 0 612 792]/BleedBox[0 0 612 792]/ArtBox[0 0 612 792]/Rotate 0>>
endobj
8 0 obj
<>stream
x}ő^3jdq $!z5 8rd߮d9|2홅]ӅzN!ƇG~ogngj!O-K?WO9՛0oO% _CmD0x*'9uਃ|h1
BݧS |̧&=S'GPNJ%a`lOGCjloMOP1 S), TD>]M&4%"S
Q$_i&)~bb(z ( +
ҕP PNRһ4)8ah'WiH>a<ЗF4>d-:i9O8 ӣղ!ɣ>}V,FԌI/%!%DCKH|4Ũ@Ĩňa
\7ҌU\<lU?͛a'(L`uʐ]q=Nڐiպ&3cIx_@̻`Zц\jaa63'Dt '[њ* QiC#)h0S7gXVT`'tJd1Dձ*@4gycK3-hl( D#JD4Lɀ#!
!CiMtNS]2
Wи%3U4Ky
Tj5昌9qgDR)fVL$bRHj5VԵE57C:`+#ŵ0Ccm13FVאlrI9յ0cu
i%f$0{klF%VjDBι(\Z.siQ6kt?MO!:HO&Z}PM5i@:_#*FLfsӴé&ub` GY) W,dq(F㩯'∃q 'U*9NbaQ+BI7yw1!|D3lPH<''1Fxv
$FKq@TD'GЍjv]bE4p<
ӒeƲkxze_J`8윉U#`<:"IO%z""v:+ŀ+Q2s3]e;Z~ܕ}+T
"YHBaՠ67f /TH0+%,XXsٶ P@+F<3K.́LX#2BkRD@}"cN\`!1/aZ3ܫ¤811B,˘>T&f;aE\L8Ww Yt*Z&Q*K1'@]Pl5/@yB/.f6ΤeX .a¬WAA
߬+݇Ú>e5$>t%7
&4448 ~a8\S0l'LVMTqfgq,0eD=Gr} 6-ro0f2F[Su±`2͢8t)Rg4aB܃M|JbQ[B.H~(*!c8d
e J.ii3c.FeEʾ² r20, S.({wU\
^ -ՖVaqЈ i5QUq\zU;a%$깭pن ɇmF1@).+M#k)^Ǵo#W)ڌs"ĬS\a/܍
s8ƾlқ
pb.0 p7N7#pP(g[6Ҝ4ag^E*Rl)`عV峈V3=j=CL(ʙnutEιI6tQAL[40CLƄdCų8A4IClK:Xk~4\,y-MJeM:4]qfqL!.f%nZYYlKuccvÖ/CRatcHT_C!S$Y > _]Sd}$e13_5Xiqbya"WL2Өm%?24gZ>
iVfh2=M
45ӑLxh"pU5tS&0Z[EaC,mHlDགྷR|OV:#-*2fw!tOXcj]7T34,Y4<A`t+
^ucT$[8b#jIJhr2#FfC *fAh歼%7#ER cGF$-ASiVG*$c.F>jAB,%7E}r4#b
/A@
aL|WHib&u
T{\W>0Gݏ[eR0 .
24?9iFz#\x{pqiKJ3 M$/UƞGe^d(K#uD㑜}έ1a0ht2hBz*qlӓw?M!="2-[8!i$1qVZ
WΒE.# %HFCfaW<]!u`
ՔjJ
0ۡU &Ee>զ:1be̞01Z\щVtiԾ
2pC˥qO\'Fz?3
qjBKaJZUdd^'QjLۼ051&٧IIPvwh