Holiday Light Display Liability Waiver

Holiday Light Display Liability Waiver
Please complete this form to participate in or host a holiday light display. Read and acknowledge the waiver before submitting.
Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address of Light Display
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Are you the homeowner or a participant?
If you are not the homeowner, please provide the homeowner's full name
Emergency Contact Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Brief Description of Your Holiday Light Display (e.g., theme, special features)
Signature (Please sign below to confirm your acknowledgment and agreement)
Powered by Jotform SignClear
Should be Empty: