Recess Cleveland Liability Release Form

Release and Waiver of Liability and Indemnity Agreement

Last edited 5/13/19
***You only have to complete a waiver with us once each calendar year. If you have already filled out this form, then please use our self check-in page to look up your profile in our system using your phone number.

If you have not filled out a wavier with Recess Cleveland before, then please fill out the form below:
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, please let me know when you're hosting other events No, I'm not interested in attending any other events

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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