Health Questionaire

Trybe Holdings LLC (Trybe)

WAIVER, RELEASE OF LIABILITY, COVENANT NOT TO SUE

In consideration of my (“I”, “my” or “myself”) and/or on behalf of my child/ward’s (each a “Ward”) participation as a competitor, volunteer (or other staff member) and/or spectator (any of the foregoing, a “Participant”) in a Trybe Summit, Trybe Misogi, or Trybe Workshop, or other Trybe Summit owned, operated, licensed or sponsored event(s) (any of the foregoing and any ancillary events/activities/operations related thereto, an “Event”), I, on behalf of myself and Ward, acknowledge, accept and agree the following:

Do you have any pre-existing medical conditions? If yes, please specify.

Have you had any surgeries or medical procedures in the last year?

Do you have any allergies? If so, please list.

Are you currently taking any medications? If yes, please list.

Are there any other physical, mental, emotional concerns you'd like to discuss?

I have read and agree to Trybe's health questionnaire

Name

First Name

Last Name

I agree to sign via digital format

Signature

Date

YYYY

I am over the age of 18

Yes

If no, please fill out the Parental Guardian information

If under 18, Parental Guardian Name

First Name

Last Name

Parental Guardian Signautre

Please type your name in for digital signature