Request edit access
Cricket for Sewa 2022 COVID19 Waiver

Activity/Event: Sports for Sewa - Cricket Match @Lincoln Park West, Jersey City 


1. I agree that I am personally responsible for my safety and actions while participating in the above activity at the Facility (344 Duncan Ave, Jersey City, NJ). I agree to comply with Jersey City/ Hudson County policies and rules, including but not limited to all Jersey City/Hudson county policies, guidelines, signage, and instructions. Because the Cricket ground 344 Duncan Ave, Jersey City, NJ is open for use by other individuals, I recognize that I am at higher risk of contracting COVID-19.  With full awareness and appreciation of the risks involved, I, for myself and on behalf of my family, spouse, estate, heirs, executors, administrators, assigns, and personal representatives, hereby forever release, waive, discharge, and covenant not to sue Sewa International, its board members, officers, agents, servants, independent contractors, affiliates, employees, successors, and assigns from any and all liability, claims, demands, actions, and causes of action whatsoever, directly or indirectly arising out of or related to any loss, damage, or injury, including death, that may be sustained by me related to COVID-19 whether caused by the negligence of the Released Parties, any third-party while at the (Lincoln Park West) or otherwise, while participating in any activity while in, on, or around the (Lincoln Park West) and/or while using any of facilities, equipment, or materials. 


2. I agree to indemnify, defend, and hold harmless the Sewa International Inc. from and against any and all costs, expenses, damages, claims, lawsuits, judgments, losses, and/or liabilities (including attorney fees) arising directly or indirectly from or related to any and all claims made by or against any of the Released Parties due to bodily injury, death, loss of use, monetary loss, or any other injury from or related to my use of the (Lincoln Park West) facilities, tools, equipment, or materials, whether caused by the negligence of the Released Parties or otherwise specifically related to COVID-19.  


3. By signing below I acknowledge and represent that I have read the foregoing Waiver of Liability, understand it and sign it voluntarily as my own free act and deed, including without limitation, the Release of Liability and Indemnification requirements contained in this document; I am sufficiently informed about the risks involved in participating in this event and to decide whether to sign this document; no oral representations, statements, or inducements apart from the foregoing written agreement, have been made; I am at least eighteen (18) years of age and fully competent; and I execute this document for full, adequate, and complete consideration fully intending to be bound by the same; or signing as a parent or guardian for a minor participant below the age of 18. 


4. I certify that I do not have any of the following COVID-19 symptoms as outlined by the Center for Disease Control: shortness of breath or difficulty breathing, fever, chills, muscle pain, sore throat, loss of taste or smell. If I develop any of the symptoms in the future, I will not attempt to participate in the event. I certify that neither I nor any member of my immediate family have been advised by health officials to self-quarantine

Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Todays Date *
MM
/
DD
/
YYYY
Team Name *
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Sewa International USA.

Does this form look suspicious? Report