Between_________________________________ (print your first and last name) and Midsouth Makers, NFP, 2804 Bartlett Rd. Suite 2, Memphis, TN 38134. By signing this agreement I acknowledge that Midsouth Makers is a dangerous place and I agree to HOLD HARMLESS Midsouth Makers, NFP, its members, its officers, and its directors.
Initials: ________
I also understand that I am personally responsible for my safety and actions and that I will follow all safety instructions and signage while at Midsouth Makers.
Initials: ________
I affirm that I am 18 years of age or older and mentally competent to sign this liability release.
Initials: ________
Name: ______________________________________
Address: _______________________________________________
Phone number: _____________________
Email: ________________________________________
Emergency Contact Name: ______________________________________
Emergency Contact Phone Number: _____________________
Signature and Date: ________________________________________
Between_____________________________ (print your first and last name) and Midsouth Makers, NFP, 2203 Freemont Rd., Memphis, TN 38114.
By signing this agreement I acknowledge that Midsouth Makers is a dangerous place and I agree to HOLD HARMLESS Midsouth Makers, NFP, its members, its officers, and its directors.
Initials: ________
I also understand that I am personally responsible for the safety and actions of my dependents and that I will ensure those individuals follow all safety instructions and signage while at Midsouth Makers.
Initials: ________
I affirm that I am 18 years of age or older, the parent or legal guardian of the dependents listed below, and mentally competent to sign this liability release.
Initials: ________
Name: ______________________________________
Address: _______________________________________________
Phone number: _____________________
Email: ________________________________________
Emergency Contact Name: ______________________________________
Emergency Contact Phone Number: _____________________
Dependants: __________________________________________________________
Parent or Legal Guardian
Signature and Date: ________________________________________