IWCA SPECIAL PROVISIONS RELATED TO THE COVID-19 VIRUS
If you participate in, enter, or attend any event listed in this premium list, you
will be deemed (without having to sign any document) to have agreed to the following indemnification, waiver of liability and assumption of risk agreement.

INDEMNIFICATION, WAIVER OF LIABILITY AND ASSUMPTION OF RISK

I acknowledge and agree that Irish Wolfhound Club of America, Inc. and each of its members, directors, governors, officers, agents, the superintendents and/or event secretary, and the owner and/or lessor or operator of the premises and any provider of services that are used to hold the event(s) and any employees or volunteers of the aforementioned parties, other participants, and any judge judging at the event (collectively, the “Released Parties”) are participating in the event(s) and allowing me to enter, participate in and/or attend the event(s) in reliance on my agreement to this indemnification, waiver of liability and assumption of risk agreement.

I understand that Irish Wolfhound Club of America, Inc. has the right to refuse my participation in, or attendance at the event(s). In consideration of permitting my participation in, or attendance at the event(s) and of the holding of this event and of the opportunity to have dogs judged and to win prizes, ribbons, or trophies:

I UNDERSTAND THAT PARTICIPATION IN, OR ATTENDANCE AT ANY EVENT(s) LISTED IN THIS PREMIUM LIST INCLUDES POSSIBLE EXPOSURE TO RISK OF SERIOUS ILLNESS AND/OR DEATH AND OTHER RISKS FROM THE COVID-19 VIRUS AND OTHER INFECTIOUS DISEASES.


I KNOWINGLY AND VOLUNTARILY ASSUME ALL SUCH RISKS, BOTH KNOWN AND UNKNOWN, EVEN IF ARISING FROM THE NEGLIGENCE OF ONE OR MORE OF THE RELEASED PARTIES, OR OTHERS AND ASSUME FULL RESPONSIBILITY FOR MY PARTICIPATION AND/OR ATTENDANCE.
 
I represent that neither I nor, to my knowledge, anyone in my household has had any illness or disease, or been diagnosed with any illness or disease relating to the COVID-19 virus or any other infectious disease in the last 30 days.


I, for myself, and on behalf of my heirs, assigns, personal representatives and next of kin, agree and hereby assume the sole responsibility for and agree to indemnify, defend, not to sue, and to hold harmless, the Released Parties from any and all liability, damage, loss, causes of action of any kind, claims, cost and expense (including legal fees) by reason of liability which may be caused or alleged to have been caused directly or indirectly to any person or imposed upon any of the Released Parties for present and future damage, because of illness, personal and bodily injuries, including death at any time resulting there from, sustained by any person or persons, including myself, or on account of damage to property, arising out of or in consequence of my participation in, or attendance at, the event(s) listed in this premium list, related to the COVID-19 virus or any other infectious disease, or however else such injuries, death or property damage may be caused, and whether or not the same may have been caused or may be alleged to have been caused by the negligence of any of the Released Parties.


I understand that this agreement is intended to be broad and inclusive to the fullest extent permitted by the laws of the state in which the event(s) listed in this premium list will take place. I agree that if any portion of this agreement is invalid or unenforceable the remainder will continue in full force and effect

I am signing this REQUEST TO PARTICIPATE AND RELEASE, voluntarily and without coercion and in consideration of the permission to participate and/or any other consideration provided to me in connection with the activities and or events described herein. I further certify that I am 18 years of age or older. If I am a minor, my parent or guardian, by signature below, fully participates in and acknowledges the contents and effect of this waiver and release on my behalf.

I HAVE READ THIS AGREEMENT FULLY AND UNDERSTAND I WILL GIVE UP SUBSTANTIAL RIGHTS BY PARTICIPATING IN OR ATTENDING ANY EVENT(S) IN THIS PREMIUM LIST, REGARDLESS OF WHETHER I SIGN A DOCUMENT.

CONTACT TRACING INFORMATION - Please fill out the form fields below.
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I fully attest to the best of my knowledge that I do not have COVID-19 at the time of attending this event. I also attest that I have NOT  been in contact with or exposed to any known carrier of COVID-19 within the past 14 days. I agree that I am attending the Irish Wolfhound Club of America, Inc. Specialty events entirely at my own risk and take full responsibility for my own health and safety during this event. I will follow all American Kennel Club (AKC), BeyRay and Irish Wolfhound Club of America, Inc. Specialty rules, requirements, procedures,  protocols, and guidelines to reduce any exposure and possibility of contracting or spreading the virus.  

I fully submit that the AKC, The Bellevue Berry & Pumpkin Ranch, Irish Wolfhound Club of America, Inc., and all other contracted staff, workers or volunteers, are in no way liable for any present or future COVID-19 exposure incurred at any time by any person, in attendance or not in attendance, during or after this event. And hereby waive all rights to file a lawsuit against the aforementioned should I be exposed to COVID-19.
Name (First Last) *
Parent or Guardian Name - First and Last (if applicable)
Phone number include Area code *
Email address *
Mailing Address *
If you answer yes to any of the following, please do not enter the show event grounds and contact a medical provider.
In the last 7-14 days have you had any of the following symptoms.  
Yes No
[_] [_] Fever (100.4 Fahrenheit or higher) or feeling feverish?
[_] [_] Chills?
[_] [_] A new or worsening cough not caused by another health condition?
[_] [_] New or worsening difficulty breathing not caused by another health condition?
[_] [_] Sore throat?
[_] [_] New or worsening muscle aches not caused by another health condition?
[_] [_] New or worsening headache that is not normal for you & not caused by another health condition?
[_] [_] New loss of sense of taste or smell?

How long have you been in Nebraska? *
Are you traveling with others? *
Where are you staying while here? *
Have you been exposed to Covid-19? *
By submitting this waiver electronically, I hereby agree to follow guidelines as directed during this event and recognize that submitting this constitutes a legal electronic signature submission for all items specified within this waiver. *
Required
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