Waiver Form

Today's Date *

MM

DD

YYYY

Parent/Guardian Name *

First Name

Last Name

Phone Number *

(###)

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Participant #1 Name *

First Name

Last Name

Participant #1 Date of Birth *

MM

DD

YYYY

Participant #2 Name

First Name

Last Name

Participant #2 Date of Birth

MM

DD

YYYY

Participant #3 Name

First Name

Last Name

Participant #3 Date of Birth

MM

DD

YYYY

Confirm Agreement *

By entering your name and checking the box below, you are providing your electronic signature and your agreement to Shredder's Waiver Terms & Conditions for yourself and for all listed participants.

I agree to Shredder's Terms & Conditions.