Mobile App Developer Insurance Waiver

Mobile App Developer Insurance Waiver
Please complete this form to acknowledge and accept the insurance waiver terms for mobile app development activities.
Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Company/Organization (if applicable)
Mailing Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Role (e.g., Developer, Team Lead, Project Manager)
Name of Mobile App or Project
Brief Description of the App/Project
Have you or your company obtained any insurance coverage for this app/project?
Signature
Powered by Jotform SignClear
Should be Empty: