____I have read the Release From Liability Waiver and understand the content.
Print Name of Participant: ________________________________
Birth Date of Participant:__________________________________
Address:__________________________________________________
City: ______________________________________________________
State: _____________________________________________________
Zip: _______________________________________________________
Email: _____________________________________________________
Phone: ____________________________________________________
Emergency Contact: ______________________________________
Relation: __________________________________________________
Venue: ____________________________________________________
Date: _____________________________________________________
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_____CHECK HERE IF THE PARTICIPANT IS A MINOR
___________________________________________________________
Print Name of Parent or Legal Guardian of Minor
___________________________________________________________
Signature (Participant or Parent/Legal Guardian if under age of 18)
