Release for Participation in Event or Activity

Activity*
Location*
SIGNATURES
Signature of Participant*
Date*

MonthDayYear
Printed Name of Participant*
First and Last Name
Signature of Parent or Guardian (If Releasor is under 18)
Date

MonthDayYear
Printed Name of Parent or Guardian (If Releasor is under 18)
First and Last Name
Signature of Releasee
Date

MonthDayYear
Printed Name of Releasee
Should be Empty:

SIGNATURES