Waiver 免責聲明
Release of Liability, Waiver of all Possible Claims and Assumption of Risks and Attestation for Self-Reporting
如實匯報、免責與放棄索償聲明
I hereby acknowledge that I have agreed to attend in person at Uplift & Innovation Commons (UNI-Commons), for the purpose of receiving services provided by UNI-Commons.
我特此確認，我同意親身到訪 UNI-Commons，為接受 UNI-Commons 提供的服務。
I acknowledge and accept that there is a risk that I could be exposed to infections such as COVID-19 while attending UNI-Commons. I also acknowledge and accept that while receiving services, UNI-Commons may need to be closer than the recommended social distancing guidelines to assess and/or treat me. I understand that UNI-Commons has informed procedures in place for infection control and public health reporting. I acknowledge and confirm that I am willing to accept this risk as a condition of attending UNI-Commons to receive services.
我確認並接受在到訪【UNI-Commons】時，我可能承受感染如COVID-19冠狀病毒的風險。我亦確認及接納在接受服務時，【UNI-Commons】為了對我作出評估及/或治療，可能需與我保持比建議的社交距離指引更近的距離。我明白【UNI-Commons】已採納公共衛生部門建議的感染控制及通報程序。我確認並確實我願意接受這風險作為我到訪【UNI-Commons】以獲取服務的條件。
In consideration of the UNI-Commons agreeing to see me in person at UNI-Commons, I agree to release the UNI-Commons, their officers, directors, employees, agents, students, externs, volunteers, and funders (the “Releasees”) from any and all causes of action, claims, demands, requests, damages or any recourse whatsoever in respect of any personal injuries or other damages which may occur or arise as a result of exposure to infection during my visit to UNI-Commons and/or through the provision of services to me by the UNI-Commons.
考慮到【UNI-Commons】同意在其服務中心向我提供會面安排，我同意免除向【UNI-Commons】、其職員、董事、僱員、代理、學生、實習人員、義工、資助機構及捐贈者（下稱「免責者」），就於我到訪【UNI-Commons】期間和/或透過【UNI-Commons】向我提供服務時，因感染而可能發生或引起的任何人身傷害或其他損失，而提出的訴訟、索賠、需求、要求、損失或任何追索權的任何及所有原因。
I do hereby acknowledge and agree that notwithstanding the generality of the foregoing, I declare that I will not commence litigation or otherwise seek to recover damages or other compensation against the Releasees based on any action, claim, demand, request, loss, or any recourse whatsoever arising from any potential or actual exposure to infections including COVID-19 while attending at UNI-Commons and/or through the provision of services to me by UNI-Commons.
我特此確認並同意，儘管上述內容之一般原則，我聲明我不會就於到訪【UNI-Commons】期間和/或透過【UNI-Commons】向我提供服務時，因任何潛在或實際感染包括COVID-19冠狀病毒而引起的任何訴訟、索賠、需求、要求、損失或任何追索權，而向免責者提出訴訟，或要求賠償損失或其他賠償。
I further acknowledge that the Releasees can rely on this Release of Liability, Waiver of all Possible Claims, and Assumption of Risk as a complete defense to any and all claims, damages, causes of action, or recourse or liability that may arise at any time.
我進一步確認，免責者可以此份《自行報告下之免責、放棄任何索償、風險承擔及陳述證明》文件作為於任何時候可能出現的任何和所有索賠、損失、訴訟成因、追索權或責任的完整抗辯理由。
I attest that I have truthfully and wholesomely declared all current and related symptoms, infections, and exposure history of me and all members attending services with me, to the best of my knowledge, to UNI-Commons representatives before the start of in-person services. I understand that UNI-Commons staff may contact me after my services for reasons required by Public Health in relation to infections and/or contact tracing.
我證實在我開始親身到訪【UNI-Commons】之前，我已盡我所知向【UNI-Commons】的代表如實並審慎地聲明了我及所有與我一起接受【UNI-Commons】服務的所有成員之所有當前及相關的病徵、感染與接觸史。我了解【UNI-Commons】職員因為公共衛生部門對感染及/或接觸者追蹤的要求之緣故，有機會在服務後與我聯繫。
I have carefully reviewed this Release of Liability, Waiver of all Possible Claims and Assumption of Risk and acknowledge that I fully understand the terms as set out above. I acknowledge that I am signing this Release of Liability, Waiver of all Possible Claims, and Assumption of Risk voluntarily.
我已經仔細查閱此份《自行報告下之免責、放棄任何索償、風險承擔及陳述證明》文件，並確認我完全理解上述條款。我確認我自願簽署此份《自行報告下之免責、放棄任何索償、風險承擔及陳述證明》文件。
By checking off the box, you agree and consent to the statement of the waiver
點選下列方塊，代表同意並理解此條款