February 27, 2021 Good Samaritan Volunteers
Time & Location
THE CHURCH OF THE LIVING GOD, MARYLAND, GENERAL RELEASE AND WAIVER OF LIABILITY NOT TO SUE IN CONSIDERATION OF individuals and families choosing to participate in Sunday Services and various programs at the Church of the Living God located at 1417 Chillum Rd, Hyattsville MD 20782.
1) I am fully aware and accept all number of risks associated with entering The Church of the Living God, Maryland Property and participating in Church programs/activities during the on-going COVID-19 Pandemic. I have read and understand the following risks due to the characteristics of the COVID-19 virus.
a) COVID-19 virus has a long incubation period and is highly contagious.
b) COVID-19 virus is easily spread from person-to-person.
c) COVID-19 may cause serious medical conditions and can lead to death.
2) By signing this consent form, I am acknowledging that this organization and all parties associated cannot be held liable if I am later diagnosed with COVID-19.
3) I hereby certify that I have the legal authority to sign this waiver on behalf of myself, my spouse, and my children. I assume full responsibility for myself, my spouse (if applicable), and my underage children (if applicable), entering onto the church premises and hereby release and hold harmless the Church of the Living God, Maryland with any respect to any and all injury, disability, death, loss, or damage to person or property, arising out of, resulting from, related to, or connected with, in any manner whatsoever, directly or indirectly, the participation or involvement of myself, my spouse (if applicable), my underage children (if applicable), participation at The Church of the Living God, Maryland.
4) I certify that I have read this General Release and Waiver of Liability in full, understand its terms, understand that certain rights will be given up by signing it, and sign it voluntarily without duress or coercion.
5) PLEASE NOTE that you are submitting an electronic form. By checking the boxes below, you are also agreeing that by typing your name into the “Primary Attendee” below, that this constitutes a binding agreement and that all information provided in the form is correct.
6) PLEASE NOTE that your body temperature will be checked prior to entering the building.
*By completing this form, you accept, understand, and acknowledge all risks associated with this event.
- Good Samaritan Attendance$0$00$0