2021 Next Gen Waiver of Liability

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WAIVER OF LIABILITY Next Gen Participant

Children must be potty trained to participate. Ages 3 and above are welcome.

Child's Name: ______________________________________ Date of Birth: ______________ _______________________________________

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List Injuries / Illness (include allergies, medications, etc.): _________________________________________________________________________ _________________________________________________________________________ Anything you would like us to know about your child(ren)...? _________________________________________________________________________ _________________________________________________________________________

Parent/Guardian Information Parent/Guardian Name: ______________________________________ Phone: ____________ Home Address: ______________________________________________________________ Email: ____________________________________________________________________ Emergency Contact (besides on-site caregiver): ____________________Phone: _____________


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