Military Liability Waiver Form
Please complete this form to participate in the designated military activity. All information is required for safety and liability purposes.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Military Affiliation
*
Please Select
Active Duty
Reserve
Veteran
Civilian Contractor
Other
Activity Name or Description
*
Date of Activity
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Do you have any medical conditions or allergies relevant to this activity?
By signing below, I acknowledge that I have read and understand the risks associated with participating in this military-related activity, and I agree to release and hold harmless the organizers from any liability arising from my participation.
*
Submit Waiver
Submit Waiver
Should be Empty: