Adult Registration

First name

Last name

PLEASE READ (click Read more) CAREFULLY AND SIGN BELOW TO INDICATE YOUR AGREEMENT. NOTE: THIS FORM INCLUDES A RELEASE OF LIABILITY:

INDICATE AGREEMENT HERE (Liability Waiver Release Statement)

Signature (Full Name) of Person Accepting This Agreement

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Phone (xxx-xxx-xxxx format)

Emergency Contact First & Last Name

Emergency Contact Phone (xxx-xxx-xxxx format)

Please place any additional comments here that you would like to include as part of this registration:

Check the box if you have any disabilities, handicaps, or present injuries or limitations, allergies, hemophilia, heart conditions, history of respiratory illness, or any other significant medical conditions?

If you checked the box, please explain here: