Before attending the Vigil of Remembrance and Lament, please read and sign the waiver and screening questions.
**Screening Questions are on page 2 of this form.**

Lakewood United Church of Christ ("Lakewood UCC" or "LUCC") COVID-19 Liability Waiver
(2021)

The staff, leadership, and community of Lakewood UCC (“LUCC”) is committed to doing our very best to keep people as safe as possible. We are enforcing mask requirements and appropriate distancing as recommended by Jefferson County,, and federal health organizations to help decrease the spread of COVID 19. Even with these precautions in place, there is still a chance of contracting COVID 19 while attending a gathering or event at Lakewood UCC. As such we are requiring all in-person participants to sign this waiver acknowledging the assumption of risk taken on by the participants.

Lakewood UCC cannot prevent you [or your child(ren)] from becoming exposed to, contracting, or spreading COVID-19 while utilizing LUCC services, activities or premises. It is not possible to prevent the presence of the disease. Therefore, you understand and agree for yourself and any minors accompanying you, if you choose to utilize LUCC services, activities and/or enter onto LUCC premises you may be exposing yourself and others to and/or increasing risk of contracting or spreading COVID-19.

ASSUMPTION OF RISK: I have read and understood the above warning concerning COVID-19. I choose to accept the risk of contracting COVID-19 for myself and my minor children in order to utilize[[delete hard return] LUCC services, activities, and enter to the premises. This in-person participation is of such value to me [and to my children,] that I accept the risk of being exposed to, contracting, and/or spreading COVID-19 in order to participate in LUCC services and activities and to be present on the premises in person.

WAIVER OF LAWSUIT/LIABILITY: I hereby forever release and waive my right to bring any claim, cause, action or suit against LUCC and all staff, employees, leadership, and other congregation members and representatives in connection with exposure, infection, injury, illness, disability or death resulting from any COVID-19 related exposure or condition from such participation. I understand that this waiver means I , for myself and for all minor children waive and give up all rights to bring any claim, cause, action or suit including for all personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen.

CHOICE OF LAW: I understand and agree that the law of the State of Colorado will apply to this contract.

I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS RELEASE, AND FREELY AND KNOWINGLY ASSUME THE RISK AND WAIVE ALL RIGHTS CONCERNING LIABILITY BY ALL NAMED PARTICIPANTS, AS DESCRIBED ABOVE: