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ex: 9998887777

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In consideration of being allowed to participate in any way in the services provided by Kevics LLC, any golf course, other facilities, and the staff, employees, independent contractors (collectively known as Service Providers) related events and activities, I, the undersigned, acknowledge, appreciate and agree that: 1. The risk of injury from the activities involved in these sport events is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and 2. I knowingly and freely assume all such risks, both known and unknown, and assume full responsibility for participation of The Member; and 3. I willingly agree to comply with the stated instructions and policies and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during the presence or participation of The Member, I will remove The Member from participation and bring such to the attention of the Service Providers immediately; and 4. I understand that if The Member is to be a passenger in any form of vehicle while traveling to and/or from or during any Service Providers related activities, I assume all liability insurance coverage; and 5. I, for The Member and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release, indemnify and hold The Service Providers, and their officers, officials, agents and/or employees, other sport participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event or activity (“Releases”) harmless with respect to any and all injury, disability, death, or loss or damage to person or property, to the fullest extent permitted by law. Do you agree that you've read and accept the Waiver of Liability statement?

I understand, agree and acknowledge that some activities may be of a hazardous nature and/or include physical and/or strenuous activity. Understanding this, I state that The Member has no medical condition or impairment that might inhibit safe and active participation in the services provided. In addition, I understand that the Service Providers do not provide medical insurance coverage for service participants and that any applicable medical insurance must be provided individually by such participants. In the case of injury or medical emergency and in the event participant, or their parent or guardian, cannot respond at the time of the emergency, the Service Providers have permission to seek, administer, or have administered whatever first aid or emergency medical care deemed necessary for participant’s welfare, and it is understood that participant, and not the Service Providers, shall be responsible for any and all charges for such health care services regardless of whether participant’s medical insurance would cover such charges. Do you agree that you've read and accept our Assumption of Risk statement?

Read these procedures with any family members that might be entering our facility. Occupancy Limit: We will not permit more than 10 people in the facility at once. Wearing Masks: This is mandatory at our facility, as well as any on-course activities we provide. If you decide to join us at the facility, everyone that enters (even parents and siblings) are required to wear a mask, even if it’s just for a short period of time to drop-off/pick-up. Physical Distancing: We have marked the facility with tape “X’s” on the ground of 6-8 feet and sectioned off boundaries on the putting green. Sanitizing Equipment: We are Clorox wiping any equipment used before and after each class, KGA staff will sanitize all equipment being used during class. Hand Sanitizer Stations: There are several hand sanitizer stations throughout the facility, it is recommended that each student uses them upon entering and exiting the different stations. NO Contact Between Players Or Coaches: Unfortunately there will be no high fives or fist bumps, and we will make sure the players are respecting the rules to avoid contact with others. NO Shared Equipment: Each player will bring their own equipment for the day (clubs and balls) and at no time will they use something someone else has touched. Bring Your Own Water: We will NOT have any water at class. NO Touching Flagsticks: This will reduce the amount of shared touch points. One Golf Cart Per Household (On-course Sessions): At no time will there be two people allowed in the same cart that do not live in the same household. Sanitize Touch Points: We are providing increased cleaning/sanitizing of all areas of high touch points around the facility. Removal From The Facility: Should any person fail to comply with these procedures, you will be asked to leave the property immediately. Do you accept that you have read and agree to these safety procedures?

Has anyone in your household traveled outside of the United States of America in the last 14 days? (Answering YES may prompt us to ask you more questions to determine if you are eligible to enter our facility before June 1, 2020.)

Has anyone in your household had contact with anyone with suspected or confirmed COVID-19 in the last 14 days? (Answering YES may prompt us to ask you more questions to determine if you are eligible to enter our facility before June 1, 2020.)

Has anyone in your household had any of these symptoms in the last 14 days: fever, chills, difficulty breathing or shortness of breath, dry cough? (Answering YES may prompt us to ask you more questions to determine if you are eligible to enter our facility before June 1, 2020.)

Is anyone in your household currently experiencing fever, difficulty breathing or cough? (Answering YES may prompt us to ask you more questions to determine if you are eligible to enter our facility before June 1, 2020.)

I (the Parent), give consent for myself (and/or the Student) to attend classes and or lessons with Kevics Golf Academy (KGA) and acknowledge that the above information in the screening questionnaire is accurate to the best of my knowledge. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending KGA 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 KGA may result from the actions, omissions, or negligence of myself and others, including, but not limited to, KGA employees, volunteers, program participants, and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at KGA or participation in KGA programming (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the KGA, 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 KGA, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any program. I understand that answering "no" will deny myself and my family from entering Kevics Golf Academy's facility and activities. Do you agree that you have read and accept the Virus & Illness Risk Acknowledgement?