COVID-19 Liability Release Waiver (PARENTS/LITTLES)

The World Health Organization has declared the novel Coronavirus (COVID-19) a worldwide pandemic. Due to its capacity to transmit from person-to-person through respiratory droplets, the government has set recommendations, guidelines, and some prohibitions which XYZ Company, LLC. (the "Organization") adheres to comply.

In consideration of my participation in the foregoing, the undersigned acknowledge and agree to the following: *

I am aware of the existence of the risk upon my and my child's physical appearance to events/venues and my and my child's participation in activities of Big Brothers Big Sisters Lincoln that may cause injury or illness such as, but not limited to Influenza, MRSA, or COVID-19 that may lead to paralysis or death. I and my child have not experienced symptoms that of fever, fatigue, difficulty in breathing, dry cough, or exhibiting any other symptoms relating to COVID-19 or any communicable disease within the last 14 days. I and my child have not, nor have any member(s) of my household, traveled by sea or by air, internationally within the past 30 days. I and my child did not, nor any member of my household, visit any any area within the United States that was reported to be highly affected by COVID-19, in the last 30 days . I and my child have not been, nor any member(s) of my household, diagnosed to be infected of COVID-19 virus within the last 30 days.

Following the pronouncements above I hereby declare the following: *

I am fully and personally responsible for mine and my child's own safety and actions while and during my participation and I recognize that I and my child may be in any case be at risk of contracting COVID-19. With full knowledge of the risks involved, I hereby release, waive, discharge Big Brothers Big Sisters Lincoln, its board, officers, independent contractors, affiliates, employees, representatives, successors, and assigns from any and all liabilities, claims, demands, actions, and causes of action whatsoever, directly or indirectly arising out of or related to any loss, damage, injury, or death, that may be sustained by me or my child related to COVID-19 while participating in any activity while in, on, or around the premises or while using the facilities and participating in related activities that may lead to unintentional exposure or harm due to COVID-19. I agree to indemnify, defend, and hold harmless Big Brothers Big Sisters Lincoln from and against any and all costs, expenses, damages, lawsuits, and/or liabilities or claims arising whether directly or indirectly from or related to any and all claims made by or against any of the released party due to injury, loss, or death from or related to COVID-19.

By signing below I acknowledge that I have read the foregoing Liability Release Waiver and understand its contents; that I am at least eighteen (18) years old and fully competent to give my consent; That I have been sufficiently informed of the risks involved and give my voluntary consent in signing it as my own free act and deed; that I give my voluntary consent in signing this Liability Release Waiver as my own free act and deed with full intention to be bound by the same, and free from any inducement or representation. This waiver will remain effective until laws and mandates relevant to COVID-19 are lifted.

Name - Parent/Guardian *

First Name Last Name

Name - Child (Little) *

First Name Last Name

Phone Number *

Email *

example@example.com

Signature - Parent/Guardian *

Clear

Date Signed *

Date