I First Name Last Name , knowingly and willingly consent to visit Scura, Wigfield, Heyer, Stevens & Cammorata, LLP during the COVID-19 Pandemic.I understand the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious. It is impossible to determine who has it and who does not given the current limits in virus testing and visible symptoms or lack thereof.I understand that due to the frequency of visits of other guests and the characteristics of the virus, that I have some risk of contracting the virus by being at the above event. I confirm that I am not presenting any of the following symptoms of COVID-19 listed below: · Fever – Temperature above 100.4 degrees· Shortness of Breath· Loss of Sense of Taste and/or Smell· Dry Cough· Runny nose· Sore ThroatTo prevent the spread of contagious viruses and to help protect each other. I understand that I will have to follow the event’s strict and posted guidelines.I understand that air travel significantly increases my risk of contracting and transmitting the COVID-19 virus and I understand the CDC, OSHA and the State of New Jersey State recommend social distancing of at least 6 feet.· I verify that I have not traveled outside of the United States in the past 14 days to countries that have been affected by COVID-19.· I verify that I have not traveled domestically within the United States by commercial airline, bus, or train within the last 14 days. Please check this box if you agree to the terms and statements above. First Name Last Name Date Signature* Below is my current phone number and best way to reach me for contact tracing purposes, should I need to be notified of a possible interaction or exposure within the 14-day incubation period: Phone Number