| Name | Yrfzhsmvwp r Gard |
|---|---|
| Date of Birth | 04/30/1991 |
| Address | Via Licola Patria 125 Rnru Gq gzudo Guardia Lombardi, AV 83040 United States Map It |
| Home Phone | (355) 295-1598 |
| Mobile Phone | (355) 295-1598 |
| Email hidden; Javascript is required. | |
| I am a competent swimmer | Yes |
| In Case of Emergency | Please provide an Emergency Contact |
| Name | Cua Lr xymg Gard |
| Home Phone | (355) 295-1598 |
| Mobile Phone | (355) 295-1598 |
| Email hidden; Javascript is required. | |
| Comments | Most of us like to partake in a little vino, a cocktail, or a nice cold brewski every now and then... And I'm one of them 🙂 However, recent studies prove the #1 sign you drink too much is excess lower belly fat (also referred to as "Liver Belly"). That's because the entire fat-burning process depends on a healthy liver. And although alcohol is normally quite damaging to your liver... The ancient Mediterranean ritual you'll see at the link below naturally protects, purifies, and rapidly cleanses your liver of EVERY form of alcohol... Allowing you to enjoy a few drinks while promoting weight loss at the same time! That's why, if you're gonna drink alcohol, just follow this simple Mediterranean Ritual beforehand (takes 30 seconds). Check it now: https://tinyurl.com/mediteraneanritual |
| Health History | The following information is requested. This information will be kept confidential and shared only when as deemed needed. Any changes to this information must be provided to the boat captain. Please provide complete information, so that we can be aware of your needs. |
| COVID-19 Vaccine | Yes |
| Allergies | Most of us like to partake in a little vino, a cocktail, or a nice cold brewski every now and then... And I'm one of them 🙂 However, recent studies prove the #1 sign you drink too much is excess lower belly fat (also referred to as "Liver Belly"). That's because the entire fat-burning process depends on a healthy liver. And although alcohol is normally quite damaging to your liver... The ancient Mediterranean ritual you'll see at the link below naturally protects, purifies, and rapidly cleanses your liver of EVERY form of alcohol... Allowing you to enjoy a few drinks while promoting weight loss at the same time! That's why, if you're gonna drink alcohol, just follow this simple Mediterranean Ritual beforehand (takes 30 seconds). Check it now: https://tinyurl.com/mediteraneanritual |
| Dietary Restrictions | Most of us like to partake in a little vino, a cocktail, or a nice cold brewski every now and then... And I'm one of them 🙂 However, recent studies prove the #1 sign you drink too much is excess lower belly fat (also referred to as "Liver Belly"). That's because the entire fat-burning process depends on a healthy liver. And although alcohol is normally quite damaging to your liver... The ancient Mediterranean ritual you'll see at the link below naturally protects, purifies, and rapidly cleanses your liver of EVERY form of alcohol... Allowing you to enjoy a few drinks while promoting weight loss at the same time! That's why, if you're gonna drink alcohol, just follow this simple Mediterranean Ritual beforehand (takes 30 seconds). Check it now: https://tinyurl.com/mediteraneanritual |
| Medications Being Taken | NO, Medications on a routine basis. |
| Do you have a history of Asthma? | Yes |
| Do you have a history of seizures? | Yes |
| Are you Diabetic? | Yes |
| Do you have abnormal blood pressure or a history of heart disease? | Yes |
| Have you ever had an anaphylactic reaction? | Yes |
| If you answered Yes, please explain. | Most of us like to partake in a little vino, a cocktail, or a nice cold brewski every now and then... And I'm one of them 🙂 However, recent studies prove the #1 sign you drink too much is excess lower belly fat (also referred to as "Liver Belly"). That's because the entire fat-burning process depends on a healthy liver. And although alcohol is normally quite damaging to your liver... The ancient Mediterranean ritual you'll see at the link below naturally protects, purifies, and rapidly cleanses your liver of EVERY form of alcohol... Allowing you to enjoy a few drinks while promoting weight loss at the same time! That's why, if you're gonna drink alcohol, just follow this simple Mediterranean Ritual beforehand (takes 30 seconds). Check it now: https://tinyurl.com/mediteraneanritual |
| Additional Information to provide | Most of us like to partake in a little vino, a cocktail, or a nice cold brewski every now and then... And I'm one of them 🙂 However, recent studies prove the #1 sign you drink too much is excess lower belly fat (also referred to as "Liver Belly"). That's because the entire fat-burning process depends on a healthy liver. And although alcohol is normally quite damaging to your liver... The ancient Mediterranean ritual you'll see at the link below naturally protects, purifies, and rapidly cleanses your liver of EVERY form of alcohol... Allowing you to enjoy a few drinks while promoting weight loss at the same time! That's why, if you're gonna drink alcohol, just follow this simple Mediterranean Ritual beforehand (takes 30 seconds). Check it now: https://tinyurl.com/mediteraneanritual |
| Food Preferences | Please check those you like & add comments where necessary |
| Food Likes |
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| Comments about Food | Most of us like to partake in a little vino, a cocktail, or a nice cold brewski every now and then... And I'm one of them 🙂 However, recent studies prove the #1 sign you drink too much is excess lower belly fat (also referred to as "Liver Belly"). That's because the entire fat-burning process depends on a healthy liver. And although alcohol is normally quite damaging to your liver... The ancient Mediterranean ritual you'll see at the link below naturally protects, purifies, and rapidly cleanses your liver of EVERY form of alcohol... Allowing you to enjoy a few drinks while promoting weight loss at the same time! That's why, if you're gonna drink alcohol, just follow this simple Mediterranean Ritual beforehand (takes 30 seconds). Check it now: https://tinyurl.com/mediteraneanritual |
| Breakfast | Hearty |
| Desserts | Most of us like to partake in a little vino, a cocktail, or a nice cold brewski every now and then... And I'm one of them 🙂 However, recent studies prove the #1 sign you drink too much is excess lower belly fat (also referred to as "Liver Belly"). That's because the entire fat-burning process depends on a healthy liver. And although alcohol is normally quite damaging to your liver... The ancient Mediterranean ritual you'll see at the link below naturally protects, purifies, and rapidly cleanses your liver of EVERY form of alcohol... Allowing you to enjoy a few drinks while promoting weight loss at the same time! That's why, if you're gonna drink alcohol, just follow this simple Mediterranean Ritual beforehand (takes 30 seconds). Check it now: https://tinyurl.com/mediteraneanritual |
| Food Dislikes | Most of us like to partake in a little vino, a cocktail, or a nice cold brewski every now and then... And I'm one of them 🙂 However, recent studies prove the #1 sign you drink too much is excess lower belly fat (also referred to as "Liver Belly"). That's because the entire fat-burning process depends on a healthy liver. And although alcohol is normally quite damaging to your liver... The ancient Mediterranean ritual you'll see at the link below naturally protects, purifies, and rapidly cleanses your liver of EVERY form of alcohol... Allowing you to enjoy a few drinks while promoting weight loss at the same time! That's why, if you're gonna drink alcohol, just follow this simple Mediterranean Ritual beforehand (takes 30 seconds). Check it now: https://tinyurl.com/mediteraneanritual |
| Bar Preferences |
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| Comments about Drinks | Most of us like to partake in a little vino, a cocktail, or a nice cold brewski every now and then... And I'm one of them 🙂 However, recent studies prove the #1 sign you drink too much is excess lower belly fat (also referred to as "Liver Belly"). That's because the entire fat-burning process depends on a healthy liver. And although alcohol is normally quite damaging to your liver... The ancient Mediterranean ritual you'll see at the link below naturally protects, purifies, and rapidly cleanses your liver of EVERY form of alcohol... Allowing you to enjoy a few drinks while promoting weight loss at the same time! That's why, if you're gonna drink alcohol, just follow this simple Mediterranean Ritual beforehand (takes 30 seconds). Check it now: https://tinyurl.com/mediteraneanritual |
| Other Additional Information | Most of us like to partake in a little vino, a cocktail, or a nice cold brewski every now and then... And I'm one of them 🙂 However, recent studies prove the #1 sign you drink too much is excess lower belly fat (also referred to as "Liver Belly"). That's because the entire fat-burning process depends on a healthy liver. And although alcohol is normally quite damaging to your liver... The ancient Mediterranean ritual you'll see at the link below naturally protects, purifies, and rapidly cleanses your liver of EVERY form of alcohol... Allowing you to enjoy a few drinks while promoting weight loss at the same time! That's why, if you're gonna drink alcohol, just follow this simple Mediterranean Ritual beforehand (takes 30 seconds). Check it now: https://tinyurl.com/mediteraneanritual |