Open House Potluck & Consent Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.What would you like to bring for the Potluck Dinner *Proteins for the grillSide DishHealthy DrinksOtherPlease provide details *I fully understand and hereby assume all of the risks and dangers by participating in this event. I participate willingly and voluntarily and assume full responsibility for any personal injury occurring as a result of any accident that may occur. I specifically understand that I, my personal representatives and my heirs are releasing, discharging and waiving any claims, actions, and losses for bodily or psychological injury, property damage, wrongful death, loss of services, or otherwise, that I may have presently or in the future, for any negligent acts or other conduct by HCA, its directors, officers, volunteers, representatives and agents. In the event that I should require medical care or treatment, I agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance. *I agreeI do not agreeName *FirstLastEmail *Today's Date *Submit