Robot Activity Liability Waiver

Robot Activity Liability Waiver
Please complete this waiver to participate in robot-related activities. Your safety and understanding of the risks are important to us.
Participant Full Name
First NameLast Name
Participant Email Address
example@example.com
Participant Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Participant Date of Birth
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contact Name
First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Do you have any relevant medical conditions or allergies we should be aware of?
I confirm that I have read and agree to the terms of the liability waiver above.
Signature of Participant (or Parent/Guardian if under 18)
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