Waiver to Hold Harmless Director Compliance Agreement
School / Organization Name
*
Name
*
First Name
Last Name
Title of Person Submitting Form
*
Email Address to Send Your Conformation
example@example.com
Please provide the number of Waivers to Hold Harmless forms you have collected
Number of Student Forms
*
Number of Adult Forms
*
Total Forms Collected
Date
*
/
Month
/
Day
Year
Date
Submit
Should be Empty: