Parent/Guardian Information & Waiver

Parent/Guardian Information & Waiver Release

* Indicates required field

Parent/Guardian Name *

First

Last

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

How did you hear about us? *

Work/Home Phone Number *

Cell Phone Number *

EMERGENCY CONTACT (OTHER THAN NAME ABOVE, AUTHORIZED TO PICK UP CHILD OR TO CALL IN AN EMERGENCY. PLEASE NOTE THAT WE WILL ALWAYS CALL PRIMARY PARENT/GUARDIAN FIRST):

Emergency Contact: Name & Phone Number *

Waiver & Photo Release

I HAVE CLICKED THE LINK ABOVE AND READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

Name & Date *