Amusement Park Liability Waiver Form
Please complete this form to acknowledge and accept the terms of participation at the amusement park.
Full Name
*
First Name
Last Name
Date of Birth
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Are you the legal guardian of the guest?
*
Yes
No
Visit 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.
Please acknowledge you have read and understand all safety rules and instructions for the amusement park.
*
I acknowledge and understand the safety rules.
Signature
*
Today's Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Waiver
Submit Waiver
Should be Empty: