Stained Glass Workshop Liability Waiver
Please complete this form to participate in the stained glass workshop. Your responses help ensure your safety and understanding of workshop risks.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Do you have any allergies or medical conditions we should be aware of?
*
No
Yes (please specify below)
If yes, please list your allergies or medical conditions:
Have you previously participated in a stained glass workshop?
*
Yes
No
Signature (please sign to acknowledge and accept the waiver)
*
Date Signed
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Waiver
Submit Waiver
Should be Empty: