Activity Waiver Form
Activity Waiver Form
Please complete this form to acknowledge the risks associated with the activity and provide consent for participation.
Name
Date of Birth
Address
Phone number
Emergency Contact Name
Emergency Contact Phone
Activity Name
Date of Activity
Location
Acknowledgment
I, the undersigned participant, fully understand and acknowledge that participation in the above-listed activity may involve risks, including but not limited to physical injury, emotional distress, and property damage. I voluntarily assume all risks associated with this activity.
Name:
Date:
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