DELHI ROCK WAIVER
This form can only be signed by a participating adult, or by a parent on behalf of their child.

We may deny admission to a person who does not meet the physical and mental needs of participation.
Sign in to Google to save your progress. Learn more
Who is participating?
 *
Only parents may submit on behalf of their children. Forward this form to the child's parent, do not submit on their behalf.
Name and age of participant:
 *
Participating in:
 *
Please write activity name. For a birthday, please write the birthday date and host's name.
Does the participant have any medical conditions which could affect their participation?
 *
As our activities are strenuous, joint pain (knees, ankles, back, shoulders, wrists, etc.) should be checked by a doctor or physio. Users should be free of pain and impairment of motion should be disclosed to prevent injury.
Please note medical conditions below. These include learning or personality related issues which could affect the ability to understand instructions.
 *
Please write "N/A" if there is nothing to disclose.
INDEMNITY, ACKNOWLEDGEMENT, WAIVER, & RELEASE FROM LIABILITY

This document is a legally binding agreement. By signing this you are acknowledging that you have read, understood and accepted the terms and conditions stated.
ACKNOWLEDGEMENT

I acknowledge the risks associated with the activities conducted by Delhi Rock and its affiliates. I acknowledge the risks associated with the use of the facilities employed by Delhi Rock and its affiliates, and that other unknown and unanticipated risks may result in injury.
RELEASE, ASSUMPTION OF RISK AND RESPONSIBILITY

In consideration and recognition of the risks of the activities I or my child undertake, I agree not to hold liable Delhi Rock or its partners, instructors, employees and affiliates, for any and all claims and demands.

I assume responsibility for and voluntarily assume the risks of any injury to me or my child and related expenses; I assume responsibility for damage to my or my child’s property; and I assume the risks for any accidents or injuries to me or my child caused by others.
I FURTHER ACKNOWLEDGE

My or my child’s obligation to follow the instructions provided; to agree to the marked, indicated and sanctioned use of the facilities employed by Delhi Rock. I permit Delhi Rock’s staff members to call emergency medical services in case I or my child are incapacitated.
IN WITNESS WHEREOF

The information provided is true to the best of my knowledge and I did not withhold any vital information. I have signed this agreement on this day.
Signature:
 *
Your first and last name in CAPITAL LETTERS
Your mobile number:
 *
Your privacy matters, we do not share or resell customer data
Address:
 *
Today's date:
 *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms