Waiver
This form is required for visitors and non-members to participate in events at our property. Thank you for your interest in our programs!
Adult Visitor's Name
*
First Name
Last Name
Child or Youth Visitor
*
First Name
Last Name
Additional Child or Visitor
First Name
Last Name
Any additional visitors?
Please list.
Parent or Legal Guardian
First Name
Last Name
Email
*
example@example.com
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Release of Liability and Waiver
This form is mandatory.
*
List all participants covered by this liability release
*
Waiver Liability Consent
*
YES- I consent to signing the Release of Liability
NO- I do NOT consent to signing the Release of Liability
Waiver Signature
*
Date
*
-
Month
-
Day
Year
Date
Photo Release
*
Yes-unrestricted
No-deny permission
Photo Release Signature
Date
-
Month
-
Day
Year
Date
Demographic Information
TRAK relies on grants to support its programs. Grantors frequently ask us for the following information, and your response is completely optional. Thank you!
Ethnicity
*
Prefer not to answer
White
Black or African-American
Asian
Native American
American Indian or Alaskan Native
From multiple races
Household income
*
Less than $10,000
$10,000-$24,999
$25,000-$49,999
$50,000-$74,999
$75,000-$99,999
$100,000-$149,999
$150,000 or greater
Prefer not to answer
Submit
Should be Empty: