Site Cleanup Liability Waiver Form

Site Cleanup Liability Waiver Form
Please complete this form to participate in the site cleanup event. Your safety and understanding of the waiver are important.
Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name
First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of Cleanup
MonthDayYear
Date
Cleanup Site Location
Are you over 18 years old?
Do you have any medical conditions or allergies we should be aware of?
Participant Signature
Powered by Jotform SignClear
Date Signed
MonthDayYear
Date
Should be Empty: