Restaurant Hot Sauce Liability Waiver Form
Please complete this form to acknowledge the risks and responsibilities associated with using or requesting our restaurant’s hot sauce.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Visit
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Table Number or Reservation Name
*
Are you 18 years of age or older?
*
Yes
No
Do you have any known allergies to spicy foods or hot sauce ingredients?
*
No, I do not have any allergies.
Yes, I have allergies (please specify below).
If you answered yes to allergies, please specify:
Emergency Contact Name and Phone Number
*
Signature
*
Submit Waiver
Submit Waiver
Should be Empty: