New Beverage Flavor Sampling Consent Form

Participant Information

Full Name Email Address Date of Birth

Consent & Acknowledgement

I understand that I am voluntarily participating in a sampling of a new beverage flavor. I acknowledge that the product contains ingredients and additives typically used in beverages.

I acknowledge that I have informed the organizers of any food allergies or dietary restrictions I may have.

Emergency Contact (Optional)

Emergency Contact Name Emergency Contact Phone

Signature

Participant Signature Date