Moving Service Release Form

Moving Service Release Form
Complete this form to provide details for your move and acknowledge the release of liability for the moving service.
Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Current Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Destination Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Preferred Move Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
List of Items to be Moved
Are there any fragile or high-value items?
Special Instructions for Movers
Do you acknowledge that the moving service provider is not responsible for damage to items not properly packed or for items not listed above?
Signature
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