Activity Waiver- Zipline and/or Climbing Wall

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Please fill in your personal information and read carefully through the terms listed. You will be asked to initial and sign (electronically) indicating you understand and agree to the terms stated.

**SPECIAL INSTRUCTIONS: You will be emailed a copy of your responses upon completing the form. Please show this email to the attendant in order to participate in the activities.

Email *

First Name *

Last Name *

Uniqname *

Your Address

Date of Birth *

YYYY

Please initial below certifying that you are 18 years of age or older. *

You must be 18 or older to participate in this activity.

The "Activity" that I am planning to participate in is a Zipline and/or Climbing Wall. The "Activity Sponsor" running these activities is Supergames. The date I am planning to participate in these activities is Tuesday, April 19, 2022. *

Please initial below if this is correct.

Participation Form, Waiver and Release of Liability

Please read the terms stated and sign below.

Please read through the terms below.

(If you are on a mobile device, unlock and turn the screen horizontal to view larger text).

I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THE ENTIRE DOCUMENT (Shown above). I HAVE READ AND UNDERSTOOD IT, AND I AGREE TO BE BOUND BY ITS TERMS. The above agreements are binding upon us, our estates, heirs, representatives and assigns. *

Please type your full name below as your electronic signature.

Today's Date *

YYYY

A copy of your responses will be emailed to the address you provided.

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