GliderCon 2018 Waiver of Liability

Please complete a separate form for each individual, whether attendance is planned for meals-only, part of or the entirety of GliderCon 2018. All fields must be completed. By completing and signing this form, you acknowledge that all hosts, officers, directors, assistants and other attendees will not be liable in the event of any type of injury, illness, accident or death. You also acknowledge that you will make every effort to abide by the safety guidelines below in order to ensure your own safety as well as the safety of those around you. For minors under the age of 18, a parent or legal guardian must sign this form on their behalf.

First Name *

Last Name *

Date of Birth * +

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number

Email Address *

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Name of primary registrant for GliderCon 2018, if this is a person other than yourself. *

I, the undersigned, acknowledge and understand that GliderCon 2018 and any member thereof
is not responsible for my welfare or for any injuries, claims or losses arising from my
participation in this event. I therefore waive any and all claims or demands against
GliderCon 2018, its officers and directors, and its participants for any injury, damage, or
pecuniary loss due to participation in the above event, no matter which portion or location of the event. Furthermore, I acknowledge that by placing my signature on this document, it is legally binding within the scope of the pertaining regulatory laws of the State of Michigan.

Signature of Attendee or Signature of Parent or Legal Guardian if attendee is under 18 years of age. *

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Name of Parent or Legal Guardian if attendee is under 18 years of age.

Date of Liability Waiver Acknowledgment * +

Emergency Contact Information

This person must be someone who is not attending the event with you.

Full Name of Emergency Contact: *

Phone Number *

Email Address *

Street Address *

City *

State *

Zip Code *