Recess Cleveland Liability Release Form

Release and Waiver of Liability and Indemnity Agreement

Last edited 5/13/19
Name of Participant *

First Name Last Name
Phone Number *

Area Code Phone Number
Name of the event you're filling out the waiver for *
E-Mail
Email *
example@example.com
Birth Date *

Month Day Year
Name of Guardian

First Name Last Name
Birth Date of Guardian

Month Day Year
Would you like to add any additional participants to this waiver?
I AM THE PARENT OR LEGAL GUARDIAN OF THE CHILD NAMED BELOW AND HAVE THE LEGAL AUTHORITY TO EXECUTE THIS CONSENT AND RELEASE.

Yes
I/WE HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I/WE HAVE READ AND UNDERSTOOD IT, AND I/WE AGREE TO BE BOUND BY ITS TERMS. *

Yes
Date

Month Day Year
at
Hour Minutes AM/PM Option
Would you like to receive FREE event updates and promotional offers from Recess Cleveland (FYI - Recess is a 501(c)(3) nonprofit and most of our events are FREE to attend)? *

Yes, subscribe me to the Recess Cleveland Newsletter. Yes, subscribe me to newsletter AND alert me when you're in my area. No, please don't notify me where there are other FREE events in my area.

Address

Would you like to volunteer at an upcoming Recess Cleveland event? *

Yes, looks like a blast. I would like to join the team. No, but I would like to learn how I can help with recess in other ways. No, not interested at this time, but thanks for asking.
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