Activity waiver form template
Acknowledgement of risk, fitness confirmation, emergency contact and typed signature for activities and classes.
6 questions · about 2 minutes to complete · free on every plan
Free account required. The template is copied into your workspace; edit anything before publishing.
- When to use it
- Before the first session or activity.
- Who it is for
- Participants in physical activities.
How to use this template
- Put the full text in the intro and require an explicit 'I agree' question.
- Collect a typed name and date as the signature.
- Keep exports; they are your record.
Questions in the activity waiver form template
1. Participant details
contact info
2. Emergency contact name and phone
open text
3. I confirm I have read the waiver and understand the risks
single choice · I confirm, I do not confirm
4. I confirm I am fit to take part and will tell staff of anything that affects this
single choice · I confirm, I do not confirm
5. Full name (typed as your signature)
open text
6. Date
date
What the results look like
IllustrativeSynthetic sample of 120 responses generated for this preview, not real survey data. Your results page shows the same charts for your own responses.
1.I confirm I have read the waiver and understand the risks
120 answered| Answer | Count | Percent |
|---|---|---|
| I confirm | 55 | 46% |
| I do not confirm | 65 | 54% |
2.I confirm I am fit to take part and will tell staff of anything that affects this
120 answered| Answer | Count | Percent |
|---|---|---|
| I confirm | 49 | 41% |
| I do not confirm | 71 | 59% |
How to read these questions
- single choice: Read the share choosing each option, then cross-tab by a segment question to see who differs.
Frequently asked questions
Is a form a valid electronic signature?
In many jurisdictions a typed name with an explicit agreement and a timestamp is acceptable for low-risk consents; for contracts, check local law or use an e-signature tool.
How long does the activity waiver form take to complete?
About 2 minutes: 6 questions, most of them single-tap. Every question can be edited, removed or reordered in the builder before you publish.
Is this template free to use?
Yes. Every template is included on the Free plan. Sign up, click Use this template, and it is copied into your workspace where you can edit it, add your logo and share it by link, email or embed.
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