In-Person Class Participation Waiver

In-Person Class Participation Waiver
Please complete this form to provide your consent and necessary information for participating in the class.
Participant Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth
MonthDayYear
Date
Class Name or Type
Class Date
MonthDayYear
Date
Emergency Contact Name
First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Do you have any medical conditions or allergies we should be aware of?
Signature (Participant or Legal Guardian if under 18)
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Additional Comments or Special Needs (optional)
Should be Empty: