LMG TRIAL NOTIFICATION REGISTRY

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1. You are entering information about yourself and that you are at least 18 years of age, and that you will enter only accurate information about yourself; OR,

2. You are registering someone who is not be able to register themselves (including individuals under the age of 18 or someone who is unable to register without your assistance) and you are the registrant's legal guardian, parent or are an otherwise legally authorized representative; you agree to the terms outlined above; and you will enter only accurate information about the registrant.