Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. The Jackson YMCA has put in place preventative measures to reduce the spread of COVID-19; however, the Jackson YMCA cannot guarantee that you will not become infected with COVID-19. Further, participation could increase your risk of contracting COVID-19.READ CAREFULLY BEFORE SIGNING – Check box for each paragraph before signingParagraph 1* By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by participation; and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the Jackson YMCA may result from the actions, omissions, or negligence of myself and others, including, but not limited to, the Jackson YMCA’s employees, volunteers, and program participants and their families. Paragraph 2* I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my participation at the Jackson YMCA. On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless the Jackson YMCA, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Jackson YMCA, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation at the Jackson YMCA. Paragraph 3* I represent that I have adequate insurance to cover any injury or illness I may suffer or cause while participating in this activity, or else I agree to bear the costs of such injury or illness myself. I further represent that I have no medical or physical condition which could interfere with my safety in this activity, or else I am willing to assume – and bear the costs of – all risks that may be created, directly or indirectly, by any such condition. Paragraph 4* In the event that I file a lawsuit, I agree to do so in the state where the Jackson YMCA is located, and I further agree that the substantive law of that state shall apply. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect Paragraph 5* By signing this document, I agree that if I am exposed or infected by COVID-19 during my participation in this activity, then I may be found by a court of law to have waived my right to maintain a lawsuit against the parties being released on the basis of any claim for negligence. Paragraph 6* I have had sufficient time to read this entire document and, should I choose to do so, consult with legal counsel prior to signing. Also, I understand that this activity might not be made available to me or that the cost to engage in this activity would be significantly greater if I were to choose not to sign this release, and agree that the opportunity to participate at the stated cost in return for the execution of this release is a reasonable bargain. I have read and understood this document and I agree to be bound by its terms. Paragraph 7* If I have signed a separate general waiver of liability connected to my participation at the Jackson YMCA, I agree that the terms of that waiver are wholly incorporated into this document and that the terms of this document are incorporated into the separate general waiver. Paragraph 8* I agree that I will practice safe social distancing and clean hygiene during my participation at the Jackson YMCA. Participant's Name* First Last Participant's Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Participant's Phone*Participant's Date of Birth* Date Format: MM slash DD slash YYYY Submission Date Date Format: MM slash DD slash YYYY Particpant's AgePARENT OR GUARDIAN ADDITIONAL AGREEMENT(Must be completed for participants under the age of 18)In consideration of being permitted to participate in this activity, I further agree to indemnify and hold harmless Releases from any claims alleging negligence which are brought by or on behalf of minor or are in any way connected with such participation by minor.Parent/Guardian Name* First Last Parent/Guardian Signature*Participant Signature*
