COA Activity & Volunteer Waiver

COA Activity & Volunteer Waiver
COA (Community Outreach Alliance) is a non-profit organization in San Clemente. We offer music activities and food for those in need, as well as resources to our community that has been deeply affected by the drug and addiction epidemic
Event Attending
Participants Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Email
example@example.com
Parent / Guardian Name ( if under 18)

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Phone Number

Area CodePhone Number
Date Completed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Please Tick to Agree
Should be Empty: