The Edge - Halfmoon

The following information will be used to complete a document that you will read and then sign. Please complete the following form to create the document. You can preview the document you will be signing

This is the person participating in any activities. If the participant is a minor, the form must be signed by a parent or legal guardian.
Participant Name

First Name *

Middle Name

Last Name *
Date of birth of the participant, not the person signing the waiver.
Participant Date Of Birth *
Email Address *

Participant Address

Address *

City *

State *

Zip/Postal *

Phone Numbers *

Home Phone

Work Phone

Cell Phone
Emergency Contact

Emergency Contact First & Last Name *

Emergency Phone *


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