Video Conferencing Platform Liability Waiver Form
Complete this form to provide your details, identify the session, acknowledge the platform waiver, and sign electronically.
Participant Information
Full Name
*
First Name
Middle Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Organization or Company Name
Role / Title
Session and Platform Details
Meeting or Event Title
*
Scheduled Session Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Platform Name or Meeting Link
*
Host or Organizer Name
Liability Waiver and Signature
Electronic Signature
*
Submit
Submit
Should be Empty: