Release of Liability PDF

Release of Liability

Step 1 of 3

- Email*
  
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- What action is the creation of this Waiver and Release of Liability form?
- Enter Activity:
- Who or what organization is being relieved of liability?
- Enter Party Name:
- What is the address of the person or group whose liability is being released?
- Address:
- City:
- State:
- ZIP Code:
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- Is this waiver for a particular person, or is it a general waiver form that participants will complete later?
- Select:
- What is the name of the person participating in the activity?
- Participant Name:
- Address:
- City:
- State:
- ZIP Code:
- Are they minor participants?
- Select if Participant is a Minor:
  - Yes
  - No
- What is the name of the minor's parent or guardian signing this waiver?:
- What is the adult's relationship to the minor?:
- Who should they call in case of an emergency?
- Emergency Contact Name:
- Contact Telephone Number:
- Contact Relationship to Participant:
- Do you want to provide an additional emergency contact?
- Second Emergency Contact:
  - Yes
  - No
- Second Emergency Contact Name:
- Second Telephone Number:
- Second Relationship:
- Would you like to add a third contact for emergencies?
- Third Emergency Contact:
  - Yes
  - No
- Third Emergency Contact Name:
- Third Relationship:
- Third Telephone Number:
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