CHELSEA COMMUNITY FAIRGROUNDS
Waiver for FairBarn
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WAIVER/RELEASE FOR COMMUNICABLE DISEASES INCLUDING COVID-19 AND INJURY ASSUMPTION OF RISK/WAIVER OF LIABILITY/INDEMNIFICATION AGREEMENT                                              In consideration of being permitted to use the Chelsea Community Fair activity center. The undersigned acknowledges, appreciates, and agrees that:1. Participation includes possible exposure to an illness from infectious diseases including but not limited to MRSA, Influenza, and COVID-19. While particular rules and personal discipline may reduce the risk, the risk of serious illness and death does exist; and,2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown and assume full responsibility for my participation; and,3. I willingly agree to comply with the stated and customary terms and conditions for participation regarding protection against infectious diseases. If, however, I observe any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such attention to nearest coach/official immediately; and,4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the Chelsea Community Fair, board members, and/or employees, WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, INJURY, AND DEATH, or loss or damage to person or property. I understand all participation is voluntary and accept the risks therein.
Signature/type name of adult attendee
For participants of minority age (under age 18 at time of participation)1. This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read andexplained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these  1. risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her releases provided above for all the releases and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releases for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above. I understand all participation is voluntary and accept the risks therein.
Parent/Guardian signature
Have you experienced any of the following symptoms in the past 48 hours?● 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● nausea or vomiting● diarrhea *
Within the past 14 days, have you been in close physical contact? (6 feet or closer for a cumulative total of 15 minutes) with:● Anyone who is known to have laboratory-confirmed COVID-19? OR •● Anyone who has any symptoms consistent with COVID-19? *
Are you isolating or quarantining because you may have been exposed to a person with COVID-19 or are worried that you may be sick with COVID-19? *
Are you currently waiting on the results of a COVID-19 test? *
Did you answer NO to ALL COVID SCREENING QUESTIONS? *
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