Wing Eating Competition Waiver
Please complete this form to participate in the competition and acknowledge the associated risks.
Participant Full Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
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 known food allergies?
*
No
Yes (please specify below)
If yes, please list your food allergies:
Do you have any medical conditions that may affect your participation?
*
No
Yes (please specify below)
If yes, please describe your medical conditions:
Have you participated in a wing eating competition before?
*
Yes
No
Participant Signature (please sign below to confirm your agreement)
*
Submit Waiver
Submit Waiver
Should be Empty: