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2015 Registration & Medical Waiver Form Town of Ellington Human Services Department/Senior Center 40 Maple Street, Ellington, CT 06029 Telephone: (860) 870-3133 Complete this confidential form to
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Registration and medical waiver is a form that individuals need to fill out in order to participate in certain activities or events.
Anyone who wishes to participate in the specific activity or event that requires the waiver.
Individuals can fill out the registration and medical waiver by providing personal information, emergency contact details, medical history, and signature to consent to the terms.
The purpose of the registration and medical waiver is to ensure that participants are aware of the risks involved in the activity or event, acknowledge their medical history, and release liability from the organizers.
Personal details, emergency contacts, medical history, and participant's signature.
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