eWaiverPro

THIS IS A DEMO ONLY

I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH THIS ATTRACTION, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.

I Agree

Initial

I certify that I am physically fit, have sufficiently prepared or trained for participation in this activity, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this activity. I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity in which I may participate, and that it will govern my actions and responsibilities at said activity.

Do you have any conditions that would interfere with your participation?

In consideration of my application and permitting me to participate in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:

(A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity.
(B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise.

I acknowledge that this activity may involve a test of a person's physical and mental limits and carries with it the potential for death, serious injury, and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, lack of hydration, and actions of other people including, but not limited to, participants, volunteers, monitors, and/or producers of the activity.

I am parent or guardian signing for a minor.

Participant's INFORMATION

First Name

Last Name

Middle Name

Phone

Date of birth (mm/dd/yyyy)

Street

City

State

Zip

Notes

Emergency Phone Number

License Number

State

Insurance Company

Policy Number

MINOR

First Name

Middle Name

Last Name

Date of Birth (mm/dd/yyyy)

Emergency Phone

Relation

Notes

MINOR

First Name

Middle Name

Last Name

Date of Birth (mm/dd/yyyy)

Emergency Phone

Relation

Notes

MINOR

First Name

Middle Name

Last Name

Date of Birth (mm/dd/yyyy)

Emergency Phone

Relation

Notes

MINOR

First Name

Middle Name

Last Name

Date of Birth (mm/dd/yyyy)

Emergency Phone

Relation

Notes

MINOR

First Name

Middle Name

Last Name

Date of Birth (mm/dd/yyyy)

Emergency Phone

Relation

Notes

MINOR

First Name

Middle Name

Last Name

Date of Birth (mm/dd/yyyy)

Emergency Phone

Relation

Notes

MINOR

First Name

Middle Name

Last Name

Date of Birth (mm/dd/yyyy)

Emergency Phone

Relation

Notes

MINOR

First Name

Middle Name

Last Name

Date of Birth (mm/dd/yyyy)

Emergency Phone

Relation

Notes

MINOR

First Name

Middle Name

Last Name

Date of Birth (mm/dd/yyyy)

Emergency Phone

Relation

Notes

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Waiver Signed for

Participant's INFORMATION

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