Electronic Activity Waiver

CCF Activity Waiver for adults and minors

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Your Name

First

Last

This form must be completed once per each individual.
If you are signing the waiver for your child/minor, please use your name and contact information.

Email Address

Phone Number

Address

Address Line 1

Address Line 2

City

State

Zip Code

Emergency contact

First

Last

Emergency contact phone number

Emergency contact relationship

Date of the event

Name of the event

Are you signing the Activity Release for your minor child?

I have read and understood the Activity Release, and am hereby signing it electronically.

Activity Release Signature

Clear Signature

Your signature will be saved on CCF records with today's date and time stamp