COVID-19 WAIVER - August Gervais, OR Trials
Competitors and Volunteers
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MUST BE SUBMITTED NO ***EARLIER*** THAN TWO DAYS BEFORE THE DAY OF YOUR PARTICIPATION. If you participate for more than one day, submit this waiver for each day of participation.
Please contact trial host, gervais.trial.2020@gmail.com if you have questions.
Name *
Email address *
Phone Number *
I represent and affirm that to the best of my knowledge and belief: (1) I do not have COVID-19 nor am I waiting for test results; *
Required
(2) I have not been tested and found positive for COVID-19 or if I have tested positive for COVID-19, I certify that I have been released by government officials and/or health care providers to resume normal activity without limit; *
Required
(3) I have not during the past 14 days experienced symptoms associated with COVID-19 including fever, coughing, or shortness of breath; and *
Required
(4) I have not within the past 14 days, to the best of my knowledge and belief, been in contact with or exposed to any known carrier of COVID-19. *
Required
I am representing my condition as of signing, and if, as of the later time of the event, there has been any change in any of the conditions represented, I am obligated to formally notify the event host of the changed conditions at the time of and before participating in the event. *
Required
I agree to follow any specific event guidelines, precautions and requirements to mitigate the possibility of event participants or attendees contracting or spreading COVID-19. I understand the risks of contracting or being exposed to COVID-19 associated with my attendance at this event, and I knowingly accept those risks.   *
Required
I agree to waive, release and hold harmless K9 Nose Work®, National Association of Canine Scent Work, LLC®, Amy Herot, Jill-Marie O’Brien, Helix Fairweather & Doglandia, LLC (Kristina Leipzig), the event location’s agents or owners, and each of their respective employees, officers, directors, agents, or contractors from and against any claim, liability, loss or expense arising out of based upon a COVID-19 infection acquired by myself or any of my family members or associates as a result of or contemporaneous with attendance or participation at this event.   *
Required
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