SUMMERCON 2026 Waiver Form

SUMMERCON 2026 Waiver Form

Complete this waiver to participate in SUMMERCON 2026. Your information ensures event safety and legal compliance.
Participant Full Name*
Additional Participant Full Name
Additional Participant Full Name
Additional Participant Full Name
Date of Birth*

MonthDayYear
Date
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Street Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
City*
State/Province*
Postal/ZIP Code*
Emergency Contact Name*
Emergency Contact Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Emergency Contact*
I have read and agree to the terms of the waiver and release for SUMMERCON 2026
Medical Conditions / Allergies
I authorize emergency medical treatment if necessary
I consent to the use of my students image in event-related media.I do NOT consent to the use of my students image in event-related media.
Acknowledgment of Risks
Parent/Guardian Name
Parent/Guardian Signature
Date (Parent/Guardian Signature)

MonthDayYear
Date
Should be Empty:

Acknowledgment of Risks