Liability Waiver and Release Form

Select activity(-ies)

Select activity(-ies)

Participant information

Full legal name

Date of birth

Email

Phone


Emergency contact

Contact name

Contact phone


Medical information & authorization

Relevant medical conditions or allergies

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Media release (optional)

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Risk acknowledgment

I understand and acknowledge that participation in the selected activities involves inherent risks, including but not limited to physical injury, and I voluntarily assume all such risks.
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Date signed

Signature

Signature