Waiver

Liability Waiver and Participant Agreement

This waiver must be completed prior to participation in training.
Participant Full Legal Name*
Date Of Birth*

MonthDayYear
YesNo
Parent/Guardian Full Legal Name*

First NameLast Name
Contact Information
Phone Number*
Format: (000) 000-0000.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email*
example@example.com
YesNo
If yes, please explain*
I Agree
Emergency Contact Information
Emergency Contact Name*
Relationship to Participant*
Release of Liability and Assumption of Risk
Signature of Participant*

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Parent/Guardian Signature*

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Printed Name of Participant*
Printed Name of Parent/Guardian*
Today's Date*

MonthDayYear
Date
Should be Empty:

Liability Waiver and Participant Agreement