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Liability Waiver

Name of event:

Name:

DOB:

Email:

Phone:

Address:

Veteran:

Gender:

Are you a person with a disability?:

If Yes:

-- Disability Type:
-- Description:
-- Date of injury/diagnosis:
-- Cause of injury:

If No:

-- Does your family member (or loved one) have a disability?:
-- Tell us more:

Is this your first Triumph Event?:

Emergency contact name:

Emergency contact number:

Are you under the age of 18?:

Parent/Guardian Name:

Relationship:

Parent/Guardian Phone:

I agree to be on-site and provide supervision during the volunteer service:

I/WE HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT I/WE HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, HAVE NOT CHANGED IT ORALLY, AND SIGN IT VOLUNTARILY.:

FOR MINOR AGE PARTICIPANTS - This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of TRIUMPH FOUNDATION and/or any of the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child's involvement or participation in these programs as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE.:

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Your legal name

Your email address

Please Confirm full name and signature.

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Signed by Andrew Skinner
Signed On: January 21, 2022

Timestamp

Audit

May 20, 2020 3:40 pm PDT

Liability Waiver Uploaded by Andrew Skinner - [email protected] IP 2600:8800:8028:4d00:35cf:5602:17a:a1fe