📋 Legal Release & Waiver

Participation Waiver & Release

Please read carefully and complete the required fields to acknowledge liability terms before participating.

1 Participant Information

First Name *

Last Name *

Date of Birth *

Email Address *

Phone Number *

Emergency Contact Name *

Emergency Contact Phone *

Relationship to Participant

2 Medical Information

Medical Conditions/Allergies

Health Insurance Provider

Policy Number

Primary Care Physician

3 Liability Release Terms

ACKNOWLEDGMENT AND ASSUMPTION OF RISK:

I am aware of the inherent risks associated with attending and participating in this event on this date. I acknowledge that physical activity involved may result in personal injury, property damage, or loss.

RELEASE AND HOLD HARMLESS:

I promise not to hold the company, its officers, agents, partners, or employees liable for any injury or loss sustained on the premises prior to, during, or after the activity. By signing this agreement, I agree to hold the organization harmless from financial responsibility or legal claims.

SAFETY COMPLIANCE:

I will follow all staff safety guidelines and instructions at all times. I confirm that I am physically fit to participate safely.

MEDICAL CONSENT:

I authorize the organization to seek emergency medical treatment for me if necessary. I understand that I am responsible for any medical costs incurred.

I have read, understood, and agree to the terms of the Participation Waiver and Release Agreement. *

4 Signature & Date

Participant Full Name (Digital Signature) *

Today's Date *

Signature Location (City, State)

I would like to receive updates about future events and activities. I consent to being photographed/videographed for promotional purposes.

Participation Waiver & Release

Waiver Signed!