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By checking "I Agree," I am confirming that I am an employee of Herschend Enterprises. I understand it is my responsibility to immediately report to the Human Resources any changes in the eligibility for myself and/or my dependents. I further understand that the information which I have supplied may be checked and that any false statements may result in disqualification. Additional documentation to substantiate the above information may be required. I consent to having Herschend Enterprises contact anyone it feels appropriate to verify any information I have given.


Verification of the above terms is required to submit this form.