Meet Your Greens - Registration
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Food For You and The Planet presented by Rosemary Ostfeld
Thursday, June 17 from 5:30 - 7:30 PM
Cinder + Salt
195 Main Street, Middletown, CT
*
Email Address *
Organization
Guest 1
Guest 2
Guest 3
I certify that I will not attend this Rockfall Foundation program if any of the following are true: I or any individual in my household have tested positive for COVID-19; or has experienced symptoms of COVID-19 in the preceding 14 days, including but not limited to, fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose. I or a member of my household has recently had close contact with a person infected with COVID-19 or I have attended large gathering of people. *
Required
I understand that if I have not received the COVID-19 vaccine I must wear a face mask to participate in this Rockfall Foundation program. I understand that if I am fully vaccinated, it is up to my discretion if I choose to wear a face mask during the program. *
Required
I understand that participation in this program involves risks of personal and bodily injury, including but not limited to possible exposure to COVID-19 and to the fullest extent permitted by law, I agree to indemnify and hold harmless The Rockfall Foundation and its directors, officers, employees, volunteers and funders from any injuries, illnesses or damages caused by or resulting from participation in this program. *
Required
I agree to notify Tony Marino at The Rockfall Foundation (860.347.0340) if I test positive for COVID-19, been exposed to someone with COVID 10 or have reason to believe that I had COVID-19 within 14 days after attending this program. *
Required
I have read this document in its entirety and I freely and voluntarily assume all risks of such as exposure to COVID 19, Injuries and Damages, as detailed above, and notwithstanding such risks, I agree to participate in this program. *
Required
Signature  (type name) *
Date *
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