Waiver Form Template

<form action="https://splitforms.com/api/submit" method="POST">
  <input type="hidden" name="access_key" value="YOUR_ACCESS_KEY">
  <input type="hidden" name="subject" value="Signed waiver">
  <input type="hidden" name="waiver_version" value="2027-01">
  <input type="hidden" name="form_loaded_at" id="form_loaded_at">

  <section>
    <h2>Release and waiver</h2>
    <!-- Paste the exact wording your lawyer approved. Do not publish this placeholder. -->
    <p>[Your waiver text: the activity, its risks, and what the participant agrees to.]</p>
  </section>

  <fieldset>
    <legend>Participant</legend>
    <label>Full legal name <input type="text" name="participant_name" autocomplete="name" required></label>
    <label>Date of birth <input type="date" name="participant_dob" required></label>
    <label>Email <input type="email" name="email" autocomplete="email" required></label>
    <label>Phone <input type="tel" name="phone" autocomplete="tel"></label>
  </fieldset>

  <fieldset>
    <legend>Emergency contact</legend>
    <label>Name <input type="text" name="emergency_name" required></label>
    <label>Phone <input type="tel" name="emergency_phone" required></label>
  </fieldset>

  <fieldset>
    <legend>Parent or guardian (only if the participant is under 18)</legend>
    <label>Parent or guardian full name <input type="text" name="guardian_name"></label>
  </fieldset>

  <label><input type="checkbox" name="agreed" value="yes" required>
    I have read this waiver, I understand it, and I agree to its terms.</label>

  <label>Type your full name as your signature
    <input type="text" name="typed_signature" required>
  </label>

  <!-- honeypot: leave empty -->
  <input type="checkbox" name="botcheck" style="display:none" tabindex="-1" autocomplete="off">

  <button type="submit">Sign and submit</button>
</form>
<script>
  document.getElementById('form_loaded_at').value = Date.now();
</script>