College Orientation Activity Waiver Form
Please complete this form to participate in college orientation activities. Your responses are required for safety and liability purposes.
Participant Full Name
*
First Name
Last Name
Student ID Number
*
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
*
-
Month
-
Day
Year
Date
Do you have any allergies or medical conditions we should be aware of?
*
No
Yes (please specify below)
If yes, please specify your allergies or medical conditions
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to Emergency Contact
*
Please Select
Parent/Guardian
Sibling
Relative
Friend
Other
Participant Signature
*
Submit Waiver
Submit Waiver
Should be Empty: