CitadelWaiverAndEmergencyContactForm .pdf

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Original filename: CitadelWaiverAndEmergencyContactForm.pdf
Title: Fandango Release
Author: Brian Haley

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The S. F. Citadel
By my Signature below, I affirm that I am 18 years of age or older. I understand that this is an erotic event for
consenting adults in which activities involving nudity, sadomasochism, dominance & submission, bondage & discipline and
other related or erotic interests and practices may take place. I waive any claim to grievances resulting from the potentially
offensive nature of such practices that I may willingly observe or willingly participate in.
I release the volunteer staff; the management & employees of The S.F. Citadel and the owners and agents of the
premises in which this event is being held from any and all liabilities for; (1) loss or theft of personal property, (2) accidents
or injury that may occur on the premises and (3) all matters civil or criminal not stated above.
Finally, as a condition of my attending this event, I state that I have read and understand the rules as written and
will abide by all decisions of the hosts and their designated representatives. I understand that failure to do so can result in my
being required to leave this event and the premises in which is being held.

Legal Name: _________________________________________________________

Address: ____________________________________ City: ______________________ State: ___ Zip: _______

Phone #/area code: ________________________________________

E-mail: _________________________________________________

Signature: _______________________________________________

Date: ________________________

(Optional) Emergency Contact Information
In case of emergency, who would you like us to contact?
Name: ________________________________________________________
Phone #/area code: ______________________________________________

Note: We require YOUR LEGAL NAME on this form. Aliases, Nicknames, Fetlife names, etc. are not acceptable.
Please be prepared to show an official ID, such as a Driver’s License, that verifies your legal name upon entrance.
If you do not want to reveal your legal name you may not attend events at the SF Citadel.
The information here will not be used for marketing purposes. It may be used in the case of medical emergency.


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