Waiver Form | 66 Fest

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I ♥ 66 Festival « October 10 & 11, 2025

Individual Consent & Waiver, Release of Liability Form

Adult Participant or Parent/Legal Guardian First Name

Adult Participant or Parent/Legal Guardian Last Name

Adult Participant Date of Birth

Month

Day

Year

Phone

Participant Email

Address

Emergency Contact

Emergency Contact Phone

1st Child Participant Name

1st Child Participant Date of Birth

Month

Day

Year

2nd Child Participant Name

2nd Child Participant Date of Birth

Month

Day

Year

3rd Child Participant Name

3rd Participant Date of Birth

Month

Day

Year

4th Child Participant Name

4th Child Participant Date of Birth

Month

Day

Year

Individual Informed Consent, Waiver, Release of Liability and Authorization for Medical Treatment

*IMPORTANT - This is a legal document. Please read carefully!

LIABILITY WAIVER:

Signature

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Acknowledgment and Agreement

By signing above, I acknowledge that I have read, understood, and voluntarily agree to the Individual Informed Consent, Waiver and Release of Liability, and Authorization for Medical Treatment, as well as all terms and conditions outlined in this agreement. I understand my signature constitutes a legally binding acceptance of these terms and that I am waiving certain legal rights, including the right to sue for injuries or damages, to the extent permitted by law.