quadrenalinqaudbikin.checkfront.co.uk
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https://quadrenalinqaudbikin.checkfront.co.uk/reserve/document/88TGS-R2PXH-3WZP5/19AF7503B9D09CEF6FD2D578596DD013286D293BF087CD8CEA71E0AF5823065C
Submission Tags: falconsandbox
Submission: On November 20 via api from US — Scanned from DE
Submission Tags: falconsandbox
Submission: On November 20 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
POST /reserve/document/sign/
<form id="document_form" method="post" class="row" role="form" action="/reserve/document/sign/">
<input type="hidden" name="template_id" value="2">
<input type="hidden" name="template_rev" value="5">
<input type="hidden" name="template_hash" value="2F729799B0B40F9F3F106488DA27091353A7DF9D138C615FB17D9F7895458D8F">
<input type="hidden" name="document_code" value="88TGS-R2PXH-3WZP5">
<input type="hidden" name="document_secret" value="19AF7503B9D09CEF6FD2D578596DD013286D293BF087CD8CEA71E0AF5823065C">
<input type="hidden" name="document_hash" value="51E401A0C6BD77406F4EA3F9DF6BD88B7FB33B81B4B056E6D4D39A82B69C0E55">
<input type="hidden" name="booking_id" value="14198">
<input type="hidden" name="guest_uuid" value="">
<input type="hidden" name="kiosk" value="">
<input type="hidden" name="return_url" value="">
<div class="col-md-9 col-lg-8">
<div id="document" class="clearfix shadow">
<span class="hidden-print document-revision">R5, 2022-10-13</span>
<div id="document_header">
<h1 class="text-center visible-print print-warning" style="margin-bottom: 100px !important;"> NOTE: Quadrenalin Quabiking Centre does not accept paper waivers, please submit electronically. </h1>
</div>
<div id="document_body" class="clearfix">
<p></p>
<div class="form-horizontal">
<div class="col-md-12">
<div class="form-group">
<label for="parent_name" class="control-label col-sm-4"> Parent name </label>
<span class="required-for"><i class="fa fa-asterisk -required"></i></span>
<div class="col-sm-8">
<input class="form-control" name="parent_name" id="parent_name" type="text" required="required">
</div>
</div>
</div>
</div>
<p></p>
<p></p>
<div class="form-horizontal">
<div class="col-md-12">
<div class="form-group">
<label for="phone_number" class="control-label col-sm-4"> phone number </label>
<div class="col-sm-8">
<input class="form-control" name="phone_number" id="phone_number" type="tel">
</div>
</div>
</div>
</div>
<p></p>
<p></p>
<div class="form-horizontal">
<div class="form-group dob_field">
<label for="date_of_birth" class="control-label col-sm-4 col-xs-12"> Date of birth<i class="fa fa-asterisk -required"></i>
</label>
<div class="col-sm-8 col-xs-12">
<div id="date_of_birth" class="birthdaypicker is_required">
<span class="hidden year-placeholder">Year</span>
<span class="hidden month-placeholder">Month</span>
<span class="hidden day-placeholder">Day</span>
<fieldset class="birthdayPicker"><select class="birthMonth span2" name="date_of_birth[birth-month]">
<option value="0">Month</option>
<option value="1">Jan</option>
<option value="2">Feb</option>
<option value="3">Mar</option>
<option value="4">Apr</option>
<option value="5">May</option>
<option value="6">Jun</option>
<option value="7">Jul</option>
<option value="8">Aug</option>
<option value="9">Sep</option>
<option value="10">Oct</option>
<option value="11">Nov</option>
<option value="12">Dec</option>
</select><select class="birthDate span2" name="date_of_birth[birth-day]">
<option value="0">Day</option>
<option value="1">01</option>
<option value="2">02</option>
<option value="3">03</option>
<option value="4">04</option>
<option value="5">05</option>
<option value="6">06</option>
<option value="7">07</option>
<option value="8">08</option>
<option value="9">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select><select class="birthYear span2" name="date_of_birth[birth-year]">
<option value="0">Year</option>
<option value="2024">2024</option>
<option value="2023">2023</option>
<option value="2022">2022</option>
<option value="2021">2021</option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
</select><input class="birthDay" name="date_of_birth" type="hidden" required=""></fieldset>
</div>
<p class="help-block"></p>
</div>
</div>
</div>
<p></p>
<p></p>
<div class="form-horizontal">
<div class="col-md-12">
<div class="form-group">
<label for="email_address" class="control-label col-sm-4"> Email address </label>
<span class="required-for"><i class="fa fa-asterisk -required"></i></span>
<div class="col-sm-8">
<input class="form-control" name="email_address" id="email_address" type="email" required="required">
<div class="mailchecker_suggestion" style="display: none;">Did you mean <a href="#"></a>?</div>
</div>
</div>
</div>
</div>
<p></p>
<p></p>
<div class="form-horizontal">
<div class="col-md-12">
<div class="form-group">
<label for="address_and_postcode" class="control-label col-sm-4"> Address and postcode </label>
<span class="required-for"><i class="fa fa-asterisk -required"></i></span>
<div class="col-sm-8">
<input class="form-control" name="address_and_postcode" id="address_and_postcode" type="text" required="required">
</div>
</div>
</div>
</div>
<p></p>
<p></p>
<p></p>
<p>I hereby wish my (<strong>CHILD) </strong></p>
<div class="form-horizontal">
<div class="col-md-12">
<div class="form-group">
<label for="full_name" class="control-label col-sm-4"> Full Name </label>
<span class="required-for"><i class="fa fa-asterisk -required"></i></span>
<div class="col-sm-8">
<input class="form-control" name="full_name" id="full_name" type="text" required="required">
</div>
</div>
</div>
</div>
<p></p>
<p><strong></strong> to take part in quad bike training to allow them to then participate in a quad bike trek at Quadrenalin Quad bike centre in Milton Keynes. I sign this document in consideration of my child being given the opportunity to
engage in this activity.</p>
<p>I AGREE AND CONFIRM THAT;</p>
<p>1. They follow commands of the instructor at all times.</p>
<p>2. I am aware motorsport is dangerous and the risks involved.</p>
<p>3. They physically and mentally able to take part in this activity.</p>
<p>4. They are over the age of 6 </p>
<p>5. I take full liability for any intentional damage, caused by their actions, to property.</p>
<p>I UNDERSTAND THAT;</p>
<p>The trek will be terminated <u>without refund</u> If they intentionally fail to follow the commands of the instructor or manoeuvre the quad bike in a manner; likely to cause injury to them, fellow participants, bystanders or damage to the
machinery.</p>
<p>RENTAL & LIABILITY</p>
<p>I hereby release, remise and forever discharge from any claims and liabilities that I might make against Quadrenalin quadbiking centre. And I make this release on behalf of my beneficiaries, executors and administrators. I agree to pay
Quadrenalin quadbiking centre the full cost of any equipment that my children use that is not returned at the end of the event. I have read and understood all the terms in this document.</p>
<p>I validate and consent that:</p>
<ol>
<li>I have read, understood and agree with all points detailed above</li>
<li>My child will pay attention to and try understand the commands given by the instructor.</li>
<li>They will try understand the basic functions of the quad bike (Braking & Accelerating and control)</li>
</ol>
<p></p>
<p></p>
<div class="form-horizontal">
<div class="col-md-12">
<div class="form-group">
<label for="i_parent" class="control-label col-sm-4"> I parent </label>
<div class="col-sm-8">
<input class="form-control" name="i_parent" id="i_parent" type="text">
</div>
</div>
</div>
</div>
<p></p>
<p></p>
<div class="form-horizontal">
<div class="form-group">
<div class="col-sm-1 hidden-xs"> </div>
<div class="input-holder col-sm-11 col-xs-12">
<label class="none" style="padding-right:0">
<input type="checkbox" name="electronic_signature_consent" id="electronic_signature_consent" value="1" required="required">
<strong>Electronic Signature Consent</strong><i class="fa fa-asterisk -required"></i>
</label>
<p class="help-block"> By checking here, you acknowledge you have read and understand the above terms, and are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request
that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special
hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature.
There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.</p>
</div>
</div>
</div>
<p></p>
<p></p>
<p></p>
<p></p>
<p></p>
<p></p>
<span class="hidden" id="age-settings" data-min-age="0" data-error-title="Error" data-error-text="You must be 0 years or older to complete this document">
</span>
<script type="text/template" id="signature_template"> <div class="signature_area modal-body clearfix">
<div class="signature_pad_wrapper">
<canvas class="signature_pad"></canvas>
</div>
<div class='signature_line tos_line signature-only col-xs-10 col-xs-offset-1'>
By submitting this form, I understand and acknowledge that the signature I have drawn above is the legal electronic representation of my signature. </div>
<div class='signature_line tos_line initial-only col-xs-10 col-xs-offset-1'>
By submitting this form, I understand and acknowledge that the initial I have drawn above is the legal electronic representation of my initials. </div>
</div>
<div class="modal-footer">
<div class="pull-left">
<button class="btn btn-default" data-dismiss="modal" type="reset">Cancel</button>
<button class="btn btn-default retry" type="button"><i class="fa fa-fw fa-undo"></i> Retry</button>
</div>
<div class="pull-right">
<button class="btn btn-success submit" type="submit">
<span class="signature-only">Add Signature</span>
<span class="initial-only">Add Initials</span>
</button>
</div>
</div>
</script>
</div>
<div id="document_footer">
</div>
</div>
<div class="text-center hidden-print submit_wrapper">
<button type="button" class="btn btn-lg btn-primary complete_button"> Submit Document </button>
</div>
</div>
<div class="hidden-print hidden-xs hidden-sm col-md-3 col-lg-4 document-sidebar">
<div id="document_sidebar" class="no-user-select">
<h2>Children's Liability Form</h2>
<em class="help-block">Please fill this document for every participant prior to attending you session</em>
<p>
<strong>Status: VIEWED</strong>
</p>
<div class="progress">
<div class="progress-bar" role="progressbar" aria-valuenow="11.11111111111111" aria-valuemin="5" aria-valuemax="100" style="width: 11.1111%;">1 / 9</div>
</div>
<div class="list-group">
<input type="hidden" id="doc_steps" value="9">
<a href="#" id="step_0" class="list-group-item clearfix">
<div class="media row">
<div class="media-left media-middle text-primary">
<span class="fa-stack fa-fw">
<i class="fa fa-square fa-stack-2x"></i>
<i class="fa fa-stack-1x fa-inverse fa-check">
<span class="step_id" style="display: none;">1</span>
</i>
</span>
</div>
<div class="media-body media-middle step_label">
Read the document </div>
</div>
</a>
<a href="#parent_name" id="step_parent_name" class="list-group-item clearfix">
<div class="media row">
<div class="media-left media-middle">
<span class="fa-stack fa-fw">
<i class="fa fa-square fa-stack-2x"></i>
<i class="fa fa-stack-1x fa-inverse">
<span class="step_id">2</span>
</i>
</span>
</div>
<div class="media-body media-middle step_label">
Fill in <strong>Parent name</strong> </div>
</div>
</a>
<a href="#phone_number" id="step_phone_number" class="list-group-item clearfix">
<div class="media row">
<div class="media-left media-middle">
<span class="fa-stack fa-fw">
<i class="fa fa-square fa-stack-2x"></i>
<i class="fa fa-stack-1x fa-inverse">
<span class="step_id">3</span>
</i>
</span>
</div>
<div class="media-body media-middle step_label">
Fill in <strong>phone number</strong> </div>
</div>
</a>
<a href="#date_of_birth" id="step_date_of_birth" class="list-group-item clearfix">
<div class="media row">
<div class="media-left media-middle">
<span class="fa-stack fa-fw">
<i class="fa fa-square fa-stack-2x"></i>
<i class="fa fa-stack-1x fa-inverse">
<span class="step_id">4</span>
</i>
</span>
</div>
<div class="media-body media-middle step_label">
Select <strong>Date of birth</strong> </div>
</div>
</a>
<a href="#email_address" id="step_email_address" class="list-group-item clearfix">
<div class="media row">
<div class="media-left media-middle">
<span class="fa-stack fa-fw">
<i class="fa fa-square fa-stack-2x"></i>
<i class="fa fa-stack-1x fa-inverse">
<span class="step_id">5</span>
</i>
</span>
</div>
<div class="media-body media-middle step_label">
Fill in <strong>Email address</strong> </div>
</div>
</a>
<a href="#address_and_postcode" id="step_address_and_postcode" class="list-group-item clearfix">
<div class="media row">
<div class="media-left media-middle">
<span class="fa-stack fa-fw">
<i class="fa fa-square fa-stack-2x"></i>
<i class="fa fa-stack-1x fa-inverse">
<span class="step_id">6</span>
</i>
</span>
</div>
<div class="media-body media-middle step_label">
Fill in <strong>Address and postcode</strong> </div>
</div>
</a>
<a href="#full_name" id="step_full_name" class="list-group-item clearfix">
<div class="media row">
<div class="media-left media-middle">
<span class="fa-stack fa-fw">
<i class="fa fa-square fa-stack-2x"></i>
<i class="fa fa-stack-1x fa-inverse">
<span class="step_id">7</span>
</i>
</span>
</div>
<div class="media-body media-middle step_label">
Fill in <strong>Full Name</strong> </div>
</div>
</a>
<a href="#i_parent" id="step_i_parent" class="list-group-item clearfix">
<div class="media row">
<div class="media-left media-middle">
<span class="fa-stack fa-fw">
<i class="fa fa-square fa-stack-2x"></i>
<i class="fa fa-stack-1x fa-inverse">
<span class="step_id">8</span>
</i>
</span>
</div>
<div class="media-body media-middle step_label">
Fill in <strong>I parent</strong> </div>
</div>
</a>
<a href="#electronic_signature_consent" id="step_electronic_signature_consent" class="list-group-item clearfix">
<div class="media row">
<div class="media-left media-middle">
<span class="fa-stack fa-fw">
<i class="fa fa-square fa-stack-2x"></i>
<i class="fa fa-stack-1x fa-inverse">
<span class="step_id">9</span>
</i>
</span>
</div>
<div class="media-body media-middle step_label">
Select <strong>Electronic Signature Consent</strong> </div>
</div>
</a>
</div>
</div>
</div>
</form>Text Content
Quadrenalin Quad biking Centre
Secure Online Booking
* Profile
* Log out
R5, 2022-10-13
NOTE: QUADRENALIN QUABIKING CENTRE DOES NOT ACCEPT PAPER WAIVERS, PLEASE SUBMIT
ELECTRONICALLY.
Parent name
phone number
Date of birth
Year Month Day
MonthJanFebMarAprMayJunJulAugSepOctNovDecDay01020304050607080910111213141516171819202122232425262728293031Year20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924
Email address
Did you mean ?
Address and postcode
I hereby wish my (CHILD)
Full Name
to take part in quad bike training to allow them to then participate in a quad
bike trek at Quadrenalin Quad bike centre in Milton Keynes. I sign this document
in consideration of my child being given the opportunity to engage in this
activity.
I AGREE AND CONFIRM THAT;
1. They follow commands of the instructor at all times.
2. I am aware motorsport is dangerous and the risks involved.
3. They physically and mentally able to take part in this activity.
4. They are over the age of 6
5. I take full liability for any intentional damage, caused by their actions, to
property.
I UNDERSTAND THAT;
The trek will be terminated without refund If they intentionally fail to follow
the commands of the instructor or manoeuvre the quad bike in a manner; likely to
cause injury to them, fellow participants, bystanders or damage to the
machinery.
RENTAL & LIABILITY
I hereby release, remise and forever discharge from any claims and liabilities
that I might make against Quadrenalin quadbiking centre. And I make this release
on behalf of my beneficiaries, executors and administrators. I agree to pay
Quadrenalin quadbiking centre the full cost of any equipment that my children
use that is not returned at the end of the event. I have read and understood all
the terms in this document.
I validate and consent that:
1. I have read, understood and agree with all points detailed above
2. My child will pay attention to and try understand the commands given by the
instructor.
3. They will try understand the basic functions of the quad bike (Braking &
Accelerating and control)
I parent
Electronic Signature Consent
By checking here, you acknowledge you have read and understand the above terms,
and are consenting to the use of your electronic signature in lieu of an
original signature on paper. You have the right to request that you sign a paper
copy instead. By checking here, you are waiving that right. After consent, you
may, upon written request to us, obtain a paper copy of an electronic record. No
fee will be charged for such copy and no special hardware or software is
required to view it. Your agreement to use an electronic signature with us for
any documents will continue until such time as you notify us in writing that you
no longer wish to use an electronic signature. There is no penalty for
withdrawing your consent. You should always make sure that we have a current
email address in order to contact you regarding any changes, if necessary.
Submit Document
CHILDREN'S LIABILITY FORM
Please fill this document for every participant prior to attending you session
Status: VIEWED
1 / 9
1
Read the document
2
Fill in Parent name
3
Fill in phone number
4
Select Date of birth
5
Fill in Email address
6
Fill in Address and postcode
7
Fill in Full Name
8
Fill in I parent
9
Select Electronic Signature Consent
MOBILE BOOKING PAGE
You will now be sent to our secure booking service.
Continue
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