Siuslaw Vision Activities Liability Waivers

Siuslaw Vision requires a waiver of liability for children to participate in our activities. You may fill out the waiver that you need here to save time at the event, through Adobe Sign.

We must have a completed waiver signed by the legal guardian of any person under the age of 18 before they may participate. This includes minors who are volunteering or working for Siuslaw Vision, such as child care assistants.

Note: This form includes space for up to 6 children on one waiver. If you have additional children, please fill out a second waiver.

FAMILY TABLE Waiver – January 6, 2023

Submit online:
Siuslaw Family Connection/Siuslaw Vision Liability Waiver


Download a form to print and bring to the event.


Fill out this form to request the waiver via email (easier to fill out on phones). This will come from Siuslaw Vision/Adobe Sign within about 24 hours.

If you have any questions, please contact or leave a message at 541-590-2425.

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