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Participant Name
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PARENTAL GUARDIAN CONSENT COVID-19 Liability Release Waiver
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 The Body of Christ Assembly, Inc. adheres to comply.
In consideration of my child’s participation in the foregoing, the undersigned acknowledge and agree to the following:
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I/my child(ren) I am aware of the existence of the risk on my physical appearance to the venue and my participation to the activity of The Body of Christ Assembly, Inc. , 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/my child(ren) have not experienced symptoms that of fever, fatigue, difficulty in breathing, or dry cough or exhibiting any other symptoms relating to COVID-19 or any communicable disease within the last 14 days.
I/ I/my child(ren) have not, nor any member(s) of my household, traveled by sea or by air, internationally within the past 30 days.
I/my child(ren) did not, nor any member of my household, visit any area within the United States that was reported to be highly affected by COVID-19, in the last 30 days.
I/my child(ren) 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 here by declare the following:
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I/my child(ren) am fully and personally responsible for my own safety and actions while and during may participation and I recognize that I may be in any case beat risk of contracting COVID-19.
With full knowledge of the risks involved, I/my child(ren)hereby release, waive, The Body of Christ Assembly, Inc. 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 related to COVID-19 while participating in any activity while in, on, or around the premises or while using the facilities that may lead to unintentional exposure or harm due to COVID-19.
I/my child(ren) agree to indemnify, defend, and hold harmless The Body of Christ Assembly, Inc. 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.
IN SIGNING THISPARENTAL GUARDIAN CONSENT FORM AND LIABILITY WAIVER, I ACKNOWLEDGE ANDREPRESENT THAT I/my child have read the foregoing agreement, understand all its provisions, and sign it voluntarily as my own free act and deed. I warrant that no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made.
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