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COVID-19 Liability Release Waiver
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.
Victory Outreach Church Of Dallas has put in place preventative measures to reduce the spread of COVID-19; however, Victory Outreach Church Of Dallas cannot guarantee that you or your family will not become infected with COVID-19, but are hoping that these measures and protocol will reduce the risk of exposure...
We will be taking extra precautions with the care of every member to include health history review and enhanced sanitation/disinfection procedures in accordance with the Texas Department of State Health Services guidance....
We require that our members to wear the following protective gear: Proper face mask, as well as well as either face shield or goggles during our services.
Victory Outreach Church Of Dallas is following these enhanced procedures to prevent the spread of COVID-19 on site:
• When arriving please be prepared to have your temperature checked by one of our Covid-19 team members
• Each Member & Visitor is required to use hand sanitizer before entering & leaving our sanctuary
• Please note that ALL surfaces will be wiped thoroughly with hospital grade (EPA) disinfectant before and after each service
By selecting below (Yes or No), I acknowledge the contagious nature of COVID-19 and the risks that I may be exposed and I assume to forego risks and accept responsibility to any illness, damage, loss, claim or liability or expense I may experience or incur in connection with our church service
By Selecting (Yes or No) at the (End of Questionnaire) I agree to each statement above and release Victory Outreach Church Of Dallas from any and all liability for the unintentional exposure or harm due to COVID-19.
Victory Outreach Church Of Dallas agrees to abide by these standards and affirms the same.
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To my knowledge, (THIS WEEK) I or my family have not been expose to COVID-19 disease..
Yes (I have been exopsed)
No (I have not been exposed)
I do not have any of the following symptoms of COVID-19 This include: Fever (100 * or higher), Fatigue, Dry Cough, Difficulty Breathing, Headaches Loss of smell and or Migraines
Yes, I have the following symptoms
No, I do not have any of the following symptoms
I understand that Victory Outreach Church Of Dallas or our church members cannot beheld liable for any exposure to the COVID-19 virus caused by misinformation on this form or the health history provided by each member & Visitor.
Yes (I agree and understand)
Please Select option (yes) to accept all terms under this waiver.....
I Acknowledge I have been truthful while conducting this questionnaire and take COVID-19 seriously
Do you have any questions for Victory Outreach Church Of Dallas?
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