Participant's Name *

Participants Age *

Date of birth

T-Shirt Size ( Adult Size)

First Name *

Last Name *

Phone *

Email *

I, the undersigned, acknowledge that participation in this event is voluntary. I hereby release the event organizers, sponsors, and affiliates from any liability for injuries, damages, or losses sustained by the participant during the event. I also understand that in the event of a medical emergency, every effort will be made to contact me. If I cannot be reached, I give permission for emergency medical treatment to be administered. *

Yes

Parent/Guardian Signature (if under 18):

Clear

Participant's Information

Parents/Guardian Information

Medical Information

Photo/Video Release

Liability Waiver & Consent