Liability Waiver For Employees Using the Haywood Gymnasium Facility

Form Section NumberDHHS-0003
Medicaid Form NumberNC-12345
Agency/DivisionNC Department of Health and Human Services (NCDHHS)
Form Effective Date 2018-10-12T12:18:00-04:00
Form File dhhs-0003.pdf

Form Content

NCDHHS Liability waiver for employees, activities leaders and class coordinators, and state employees' spouses and children 18 years old or older using the Haywood Gymnasium facility.