Dance Event Liability Release Waiver Form
Complete this waiver to participate in the dance event and confirm your agreement to the release terms.
Participant Information
Participant Full Name
*
First Name
Middle Name
Last Name
Date of Birth
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Event Participation Details
Dance Event Name
*
Event Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Participation Role
*
Please Select
Attendee
Performer
Volunteer
Staff
Other
Liability Release and Emergency Consent
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Participant Signature
*
Submit
Submit
Should be Empty: