Swimming With Dolphins Waiver and Liability Claim Form
Complete this form to register for the dolphin-swimming activity, provide contact and emergency details, and acknowledge the activity waiver and liability terms.
Participant Details
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
Phone Number or Email Address
*
Please enter a valid phone number.
Format: (000) 000-0000.
Activity Information
Swim Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Preferred Session Time
*
Morning
Afternoon
Evening
Other
Number of Participants
Special Participation Notes
Emergency and Safety Information
Emergency contact name
*
Emergency contact phone number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Health and safety caution acknowledgment
*
Yes, I acknowledge
No
Submit Form
Should be Empty: