Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19
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A waiver form MUST be signed prior to your child(ren) participating in any YIA event/program/practice.
The novel coronavirus, 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. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. Wabash Valley Youth in Action, Inc. (“YIA”) has put in place preventative measures to reduce the spread of COVID-19; however, the YIA cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending YIA practices/games could increase your risk and your child(ren)’s risk of contracting COVID-19.--------------------------------------------------------------- By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending YIA and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the YIA practices/games may result from the actions, omissions, or negligence of myself and others, including, but not limited to, YIA employees, volunteers, and program participants and their families.I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at YIA practices/games or participation in YIA programming (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the YIA, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the YIA, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any YIA program. *
Print Name of Parent/Guardian of YIA participant *
Print Name of YIA participant(s) *
Date signed *
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A copy of your responses will be emailed to the address you provided.
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