Personal Liability Form
Personal Liability Form
Please read and complete this form carefully to acknowledge and accept the risks involved in participating in an activity or using certain services.
Participant Information
Name
Date of Birth
Phone Number
Activity/Service Information
Description of Activity/Service
Date of Activity/Service
Emergency Contact Information
Name
Relationship to Participant
Phone Number
Additional Notes or Restrictions (Optional)
Liability Waiver Statement
I, [Your Name], hereby acknowledge that I have voluntarily chosen to participate in the above activity or service. I understand that there may be risks, including but not limited to personal injury, that may arise from my participation. I agree to release and hold harmless [Your Company Name], its employees, and its affiliates from any liability, claims, or damages that may result from my participation.
Signature
Name:
Date:
By submitting this form, I confirm that I have read and understood the above waiver and accept its terms.
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