Nonprofit Participation Waiver Form
Please fill out this waiver form before participating in our nonprofit activities.
Participant Full Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Please read and agree to the terms and conditions below.
I hereby waive any liability and agree to participate at my own risk. I understand the nature of the activities and accept all responsibility for any injury or damage that may occur.
Signature of Participant
*
Date of Signature
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: