Pool Light Installation Waiver Form

Pool Light Installation Waiver Form
Please complete this form to request pool light installation and acknowledge the waiver terms related to the work.
Customer and Site Details
Customer Full Name
First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Service Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Installation Information
Requested Installation Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Pool Type / Setup Context
Existing Pool/Electrical Conditions or Known Issues
Waiver and Authorization
Authorized Signature
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Additional Contact and Access
Emergency Contact Name
First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Access Instructions
Should be Empty: