Membership Waiver and Liability Release
Please complete this form to acknowledge and accept the terms of the membership waiver and liability release.
Participant Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name and Phone Number
*
Waiver and Liability Release Statement: By participating in this membership activity, you acknowledge and accept all risks involved. You agree to release the organization and its representatives from any liability for injuries or damages that may occur as a result of your participation. Please read this statement carefully before proceeding.
*
Participant Signature (Please sign below to confirm your agreement)
*
Date of Agreement
*
-
Month
-
Day
Year
Date
Submit Waiver
Submit Waiver
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