Pelican Bayou Counseling Agency

I, the client, hereby give consent for myself to be transported by Pelican Bayou Counseling Agency Inc. staff. I agree that upon me riding in any vehicle provided by PBCA, I hereby release and discharge PBCA from all claims, demands, damages, actions and from any and all liability of any nature whatsoever for any injury, harm or complication that may result directly or indirectly by reason of ... ................
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