Participation Waiver

Junior Participation Waiver

Please fill out the following form
in order to participate in our activity.

Junior's First Name

Junior's Last Name

Junior's Date of Birth

Parent/Legal Guiardian's Full Name

Parent/Legal Guardian's Phone Number

Parent/Legal Guardian's Email

Juniors must be aged between 12 & 17 to participate in GBSUP Events. Juniors should always be accompanied at an event by an legal adult at all times.

Have you been hospitalized in the last 12 months?

Yes

Are you suffering from a medical condition, illness, or injury?

Yes

I confirm that I can swim 50m unaided and I will bring any medication I need of my person for my particpation

If you answered yes to any question, please elaborate

Parent/Legal Guardian's Initials

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!