Waiver | Spiral Arts Studio

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Liability Waiver

First Name

Last Name

Email

Date of Birth

Please specify anything we should know about

Emergency Contact and Phone number

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

I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any activity at Spiral Arts Studio. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.

Digital Signature

Thanks for submitting!

Estudio de artes en espiral

750 calle principal

Willimantic, CT 06226

spiralartscenter@gmail.com

(860) 377 58 26

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