Waiver | Goat Pose Events

Liability Waiver &
Appearance Release Form

First name

Last name

Date of Birth

Phone

Do you have a doctor’s permit to participate in intense physical activities?

Yes

Please specify anything we should know about

I declare that the info I’ve provided is accurate & complete

I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.

I hereby give my consent to use my photographs and other forms of media I am captured in according to the terms & conditions

I accept terms & conditions

Initials

Thanks for submitting!

Liability Waiver & Appearance Release Form

Liability Waiver &
Appearance Release Form