Request edit access
Assumption of Risk and Waiver of Liability
The World Health Organization has declared the Coronavirus (“COVID-19”) a worldwide
pandemic. It is extremely contagious and believed to spread primarily through person-to-person contact. As a result, the Federal government and State of Nevada has mandated social distancing and limited group assemblies.
Daybreak Christian Fellowship (“Daybreak”) has implemented preventative measures to reduce
the spread of COVID-19; but cannot guarantee that you or your children will not become
infected. Further, attending church and/or church-related activities (“events”) could increase
yours and your children’s risk of contracting COVID-19.
By signing this agreement, you acknowledge the contagious nature of COVID-19 and voluntarily
assume the risk that you and your children may be exposed to or infected by attending events,
and that such exposure or infection may result in personal injury, illness, permanent disability,
and death. You understand the risk of becoming exposed to or infected by COVID-19 at
Daybreak events may result from the actions, omissions, or negligence of Daybreak officers,
employees, and volunteers; the event participants and their families.
You voluntarily agree to assume the foregoing risks and accept sole responsibility for any illness, injury, or death to your children or yourself in connection with attendance or participation in a Daybreak event.
On your behalf, and on behalf of your children, you hereby release, discharge, and hold harmless
Daybreak, its employees, agents, and representatives from any claims, liabilities, damages, costs or expenses of any kind arising out of or relating thereto.
I agree to follow the guidelines of Daybreak when attending services such as sanitizing my hands, social distancing, bathroom etiquette, refraining from physical contact.
Sign in to Google
to save your progress.
I agree that the laws of the State of Nevada will apply to this Waiver of Liability. I am the parent/legal guardian of the minor(s) named below
I have read and fully understand all provisions of this Waiver of Liability, and freely and knowingly assume the risk and waive my rights concerning liability as described above
I have the legal right to consent to and, by signing below, I hereby consent to the terms and conditions of this Waiver of Liability.
First/Last name of person completing this form
Never submit passwords through Google Forms.
This form was created inside of EMG.