Forms > Waiver and Release Form

Waiver and Release Form

A Waiver and release for is a legal document that is filled by an individual to give assurance about his/her consent for any activity/event. Through this form, the individual accept all the liabilities including dangers, loss, and benefits as well that may occur during that event.

Sample Waiver and Release Form

General Information

First Name___________ Last Name__________

Sex_______ Age_________ Enclose prove of age_____________

Address____________ City/State_____________ Zip___________

Phone____________ Email___________ Fax____________

Waiver and Release Information

Title of Activity/Event prospected for waiver and release____________________

Date of event__/___/___ Duration: From____ To ______

Nature of Activity/Event_______________

Brief Description of Event_______________

Have you read the terms and conditions very well_____________

Do you agree with them, if yes than check the box____________

Are you well aware of those dangers and risks related with this activity________________

Enclose the certificate of physical and mental fitness by registered doctor_______________

Declaration

I hereby declare that I agree with above terms and conditions.

Signature______________ Date of submission___/___/____

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