Atlantic Indemnity Waiver Form

Please fill out the following form to acknowledge and accept any potential risks involved and release liability.

Rider Details

First Name

Last Name

Phone Number

Date of Birth

Activity/Event Name

Any injuries/illness/allergies we need to know of?

Emergency Contact Details

First Name

Last Name

Phone Number

Acknowledgement

I acknowledge that I have read and understand the risks involved in the activity/event. I understand that participation in the activity/event is voluntary. I release Atlantic Surf , its employees or contractors from any liability for injuries or damages that may occur during the activity/event. I agree to abide by all rules and instructions provided by Atlantic Surf.