Download Copy "*" indicates required fields Today's Date* Month Day Year Guest Name* First Last Guest Email* Phone*Guest of:* First Last Consent*As a non-member/guest of Palm Harbor Newcomers Club (PHNC), I agree to hold harmless and in the future, without fault and free from damages, Palm Harbor Newcomers Club, the members of PHNC Executive Board, the members of the PHNC General Board, as well as all other PHNC members, in the event of any accident, injury or harm which may occur at, during or traveling to and from a PHNC activity, gathering or other event. This waiver remains in effect from January 1st and ends December 31st of the year initiated. I agree to the PHNC waiverSignatureThis field is hidden when viewing the formLuncheon Attendence count First visit Second visit CAPTCHAEmailThis field is for validation purposes and should be left unchanged.
