Asbury Woods Program Waiver
ASSUMPTION OF RISK, RELEASE AND INDEMNITY AGREEMENT

This is a legally binding document.  It waives and releases certain legal rights.  Please read it carefully before signing it.

Please read the Asbury Woods Program Waiver here: https://www.asburywoods.org/assets/pdfs/AsburyWoods_programwaiver.pdf?vid=6
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Program Name *
Program Date *
MM
/
DD
/
YYYY
Participant Name *
Participant Phone Number *
Participant Age *
Parent or Guardian Name if participant is a minor
Participant E-mail Address *
Emergency Contact Name *
Emergency Contact Phone Number *
Emergency Contact Relationship to Participant *
I acknowledge that I have carefully read and fully understand this acknowledgement, assumption of risk, release and indemnity agreement. I have had all of my questions answered to my satisfaction by Asbury Woods and knowingly and willingly assume all risks. I intend to be legally bound by this agreement.
Participant electronic signature (type your full name) *
IF PARTICIPANT IS UNDER 18 YEARS OF AGE
As parent/guardian of the participant, intending to be legally bound, I on behalf of the minor-participant, hereby agree to all terms and provisions stated on the above portion of this form.
Parent/Guardian electronic signature (type your full name)
In case of emergency, may we have permission to seek medical treatment for your child? *
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