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SHAC - Liability Waiver

Sky High Adventure Center Inc.
PO BOX 236, Sand Lake, NY 12153

SHAC Center (Physical Location)
27 Lake Ave, Averill Park, NY 12018

LIABILITY WAIVER: In consideration of my selected program(s), I do hereby for myself, heirs, executors, or assigns waive and release any and all rights and claims for damages I may have against Sky High Adventure Center Inc., and any and all sponsors and their representatives, and assigns or any official or participant for any and all injuries I may suffer in connection with Sky High Adventure Center Inc. Programs, property or facilities. Further, I stipulate that I am physically fit and capable to participate in the program(s) selected. And I hereby grant full permission to any and all the foregoing to use any photographs, videotapes, motion pictures, recordings or any other record of this event for any legitimate purpose.

Other (detail)

If other is selected above, enter your event or program here.

Contact Information

Name - Legal Name or Guardian's Full Name if under 18 years of age

First Name

Last Name

Verify Email

Phone

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Youth Participant's Full Names and ages, separated by commas

Example: John Smith 8, Suzie Jones 10

Emergency Contact - Name and Phone

Special Medical or Behavioral Conditions (if None Please Write NONE)

Include any allergies, medications, or other special conditions.

Legal Guardian's Signature

Typing your full legal name serves as your digital signature.

Communication Preferences

We recommend receiving all news and updates from SHAC! (unchecked)

Do not call

Do not email

Do not mail