COVID Waiver
Please read this form carefully for important COVID information for the 2021 Barracudas Season
Email *
Swimmer's First and Last name *
Parent/Guardian First and Last Name *
The 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 Barracudas Swim Team and Missouri Western State University (MWSU) have put in place preventative measures to reduce the spread of COVID-19; however, these entities cannot guarantee that you will not become infected with COVID-19. Further, participation could increase your risk of contracting COVID-19.                                                         Please type your initials below  to indicate you have read and understood the above warning *
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 MWSU may result from the actions, omissions, or negligence of myself and others, including, but not limited to, MWSU/Barracudas employees, volunteers, and program participants and their families.         Please type your initials below  to indicate you have read and understood the above information *
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 MWSU/Barracudas. On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless MWSU/Barracudas, 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 MWSU/Barracudas, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation at MWSU/Barracudas.   Please type your initials below  to indicate you have read and understood the above information. *
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. Please type your initials below to indicate you have read and understood the above information *
In the event that I file a lawsuit, I agree to do so in the state where MWSU/Barracudas 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. Please type your initials below to indicate you have read and understood the above information *
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.  Please type your initials below to indicate you have read and understood the above information *
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. Please type your initials below to indicate you have read and understood the above information *
If I have signed a separate general waiver of liability connected to my participation at MWSU/Barracudas, 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. Please type your initials below to indicate you have read and understood the above information *
I agree that I will practice safe social distancing and clean hygiene during my participation at MWSU/Barracudas, INCLUDING following posted mask policies. Please type your initials below to indicate you have read and understood the above information *
In consideration of the athlete named above 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 athlete related to Covid-19. Please type your initials below to indicate you have read and understood the above information *
Electronic Waiver Agreement: I agree to my electronic signature being used as evidence of agreement. *
Required
Please type your FULL name below *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy