Student Organization Event Liability Waiver Form
Complete this form to participate in the student organization event and acknowledge the liability waiver.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Name of Student Organization Hosting the Event
*
Event Name
*
Event Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Emergency Contact Name
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Signature
*
Submit Waiver
Submit Waiver
Should be Empty: