Liability Release Form: LiabilityRelease_2018 First Name Student Info Last Name Student Info Address City State Zip Code Phone Parent/Guardian info if student is under 18 Email Parent/Guardian info if student is under 18 Date of Birth Guardian info If student is under 18 Emergency Contact (name) Emergency Contact (phone) Waiver Complete Yes No Waiver has been read, agreed to, and signed by student (if over 18) or parent/guardian (if student is under 18). Mailing List Do you want to receive our newsletter and occasional announcements? Ideas? What changes would you like to see? What would you like to do more of in the future?