Dominique Paesano Waiver & Liability Release
Please complete the following waiver for each adult and child in your household. Complete a SEPARATE form for each person.
Name
*
First Name
Last Name
Email
*
example@example.com
Today's Date
*
-
Month
-
Day
Year
Date
Phone Number
*
-
Area Code
Phone Number
*Complete a SEPARATE waiver for yourself and each child.* If signing this waiver for a minor, please enter child's name and age below
Minor's name, age
Disclaimer
LIABILITY & RELEASE WAIVER
Submit
Should be Empty: