Waiver | Theatre33 WA

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Theatre33 classes and events liability waiver

Participant name

Date of Birth

Parent/Guardian name

Email

Phone

Do you have any medical problems/allergies?

No

Yes

Please specify anything we should know about

Signature

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.

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1632 116 Ave. NE, Suite D, Bellevue, WA 98004

Tel: (425) 260-7618

theatre33.wa@gmail.com

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