Loading...

2024 Offsite Activity Participant Release

In consideration of the opportunity to participate in South Carolina Aquarium [“Aquarium”] Offsite Activities for the year 2024, I agree to release and indemnify the Aquarium, its employees, officers, Board of Directors, and agents from any and all claims of any nature related to or arising out of any and all activities during any trip that may be made against any of them.

I also agree, consent to, and authorize the Aquarium to administer and seek necessary medical care that may be required for any injuries I sustain while participating in any activity, the expense for which I agree to be responsible.



First Participant Name

First Name*

Last Name*

Phone*
First Participant Date of Birth*
First Participant Allergy/Medication Information

I further represent that I do not have any physical or mental conditions that restrict or prevent me from participating in any activities. I have listed below my allergies and required medications that may entail special attention.



List any allergies and medications including individual(s) name(s)

List any medication(s)
First Participant Signature*
Second Participant Name

First Name*

Last Name*
Second Participant Date of Birth*
Second Participant Allergy/Medication Information

I further represent that I do not have any physical or mental conditions that restrict or prevent me from participating in any activities. I have listed below my allergies and required medications that may entail special attention.



List any allergies and medications including individual(s) name(s)

List any medication(s)
Third Participant Name

First Name*

Last Name*
Third Participant Date of Birth*
Third Participant Allergy/Medication Information

I further represent that I do not have any physical or mental conditions that restrict or prevent me from participating in any activities. I have listed below my allergies and required medications that may entail special attention.



List any allergies and medications including individual(s) name(s)

List any medication(s)
Fourth Participant Name

First Name*

Last Name*
Fourth Participant Date of Birth*
Fourth Participant Allergy/Medication Information

I further represent that I do not have any physical or mental conditions that restrict or prevent me from participating in any activities. I have listed below my allergies and required medications that may entail special attention.



List any allergies and medications including individual(s) name(s)

List any medication(s)
Fifth Participant Name

First Name*

Last Name*
Fifth Participant Date of Birth*
Fifth Participant Allergy/Medication Information

I further represent that I do not have any physical or mental conditions that restrict or prevent me from participating in any activities. I have listed below my allergies and required medications that may entail special attention.



List any allergies and medications including individual(s) name(s)

List any medication(s)
Sixth Participant Name

First Name*

Last Name*
Sixth Participant Date of Birth*
Sixth Participant Allergy/Medication Information

I further represent that I do not have any physical or mental conditions that restrict or prevent me from participating in any activities. I have listed below my allergies and required medications that may entail special attention.



List any allergies and medications including individual(s) name(s)

List any medication(s)
Seventh Participant Name

First Name*

Last Name*
Seventh Participant Date of Birth*
Seventh Participant Allergy/Medication Information

I further represent that I do not have any physical or mental conditions that restrict or prevent me from participating in any activities. I have listed below my allergies and required medications that may entail special attention.



List any allergies and medications including individual(s) name(s)

List any medication(s)
Eighth Participant Name

First Name*

Last Name*
Eighth Participant Date of Birth*
Eighth Participant Allergy/Medication Information

I further represent that I do not have any physical or mental conditions that restrict or prevent me from participating in any activities. I have listed below my allergies and required medications that may entail special attention.



List any allergies and medications including individual(s) name(s)

List any medication(s)
Ninth Participant Name

First Name*

Last Name*
Ninth Participant Date of Birth*
Ninth Participant Allergy/Medication Information

I further represent that I do not have any physical or mental conditions that restrict or prevent me from participating in any activities. I have listed below my allergies and required medications that may entail special attention.



List any allergies and medications including individual(s) name(s)

List any medication(s)
Tenth Participant Name

First Name*

Last Name*
Tenth Participant Date of Birth*
Tenth Participant Allergy/Medication Information

I further represent that I do not have any physical or mental conditions that restrict or prevent me from participating in any activities. I have listed below my allergies and required medications that may entail special attention.



List any allergies and medications including individual(s) name(s)

List any medication(s)
Parent or Guardian's Email Address

Email*

Confirm Email*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
South Carolina Aquarium Photography and Film Release
Thank you for supporting the South Carolina Aquarium. South Carolina Aquarium retains ownership and rights to any and all photography and videography (assets) captured. Assets are intended for use in South Carolina Aquarium marketing initiatives including, but not limited to: broadcast media and public relations efforts, advertising campaigns, promotional collateral and publications, audio-visual presentations and owned media channels.*
Yes, I agree to be photographed/filmed
No, I DO NOT agree to be photographed/filmed
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Allergy/Medication Information

I further represent that I do not have any physical or mental conditions that restrict or prevent me from participating in any activities. I have listed below my allergies and required medications that may entail special attention.



List any allergies and medications including individual(s) name(s)

List any medication(s)
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!