Top Tier Columbia COVID-19 Waiver
Top Tier Columbia is excited to begin its return to fitness initiative at this time. Classes will follow CDC guidelines that best meet the safety needs of all of our athletes and coaching staff. You must complete this waiver at least 1 hour prior to each class. If you have any questions please feel free to contact Jason Schreiber.
Email address *
First Name *
Last Name *
Which class will you be attending? *
What is your current temperature? If you are exhibiting a temperature of 100.4 or higher, please do not attend class. Temperatures will also be taken at the gym by the coaches upon arrival. * *
At this time, I do not exhibit any signs and/or symptoms of the Coronavirus including high fever, difficulty breathing, persistent pain or pressure in chest area, inability to stay awake, bluish lips/face, loss of taste or smell, and/ or confused. *
Are you exhibiting any signs or symptoms of Coronavirus? *
Top Tier Columbia, LLC Covid-19 Waiver of Liability And Indemnity Agreement.
I understand that Top Tier Columbia, LLC (“TTC”) is working to return to fitness in a safe and responsible fashion and will be attempting to follow applicable guidelines and limitations imposed and/or suggested by national, state, and local authorities. I understand that my participation in TTCs’ return to fitness programming is voluntary. I understand that my decision to participate in TTCs’ return to fitness programming is based upon my full understanding of the risks associated with Covid-19 and considers my family’s unique health, safety, and risk situation and preferences. If I choose to participate in TTCs’ return to fitness programming, I, for myself agree to comply with all TTC policies and rules. I understand that Covid-19 infections, illnesses, and deaths have occurred across the United States of America and in the state of Maryland, including many, if not all, of the counties in Maryland. If I choose to participate in TTCs’ return to fitness programming, I understand that there is an increased risk that I, my family, my co-workers, and anyone else with whom I may come into contact or close proximity, may be exposed to and/or contract Covid-19. Waiver And Indemnification: With full awareness and appreciation of the risks involved, I, for myself and on behalf of my spouse, family, estate, heirs, executors, administrators, assigns, and personal representatives, hereby forever release, waive, discharge, indemnify, and covenant not to sue TTC, its board members, owners, officers, agents, servants, coaches, assistant coaches, volunteers, organizers, helpers, independent contractors, affiliates, employees, successors, and assigns (collectively the “Released Parties”) 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, my spouse, or my family related to Covid-19 whether caused by the negligence of the Released Parties while participating in the TTC return to fitness programming. By indicating Yes in the box below I acknowledge and represent that I have read the foregoing Waiver of Liability and Indemnity Agreement, understand it and sign it voluntarily as my own free act and deed. I further acknowledge and state that no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made. I further agree that this agreement shall be governed by and construed in accordance with Maryland law, and that if any of the provisions hereof are found to be unenforceable, the remainder shall be enforced as fully as possible and the unenforceable provision(s) shall be deemed modified to the limited extent required to permit enforcement of the agreement as a whole. *
Do you assume all risks and liability as stated in the above statement?
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A copy of your responses will be emailed to the address you provided.
A copy of your responses will be emailed to the address you provided.
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