Campfire Liability Waiver Form

Campfire Liability Waiver Form
Please complete this form to participate in campfire activities and acknowledge the associated risks.
Participant's Full Name
First NameLast Name
Date of Birth
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contact Name
First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Emergency Contact
Do you have any allergies or medical conditions we should be aware of? If yes, please specify.
Date of Campfire Participation
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Participant's Signature
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