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Liability Waiver
Participant's Name (if 18+) or Parent/Legal Guardian
First Name
Last Name
Date of Birth
Participants' Names (under 18) *
Email
Phone
Emergency Contact
Emergency Contact Number
Initials
I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.
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