Lanier Soccer Association Referee Program Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19
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. Lanier Soccer Association cannot guarantee that you will not become infected with COVID-19. Further, participation could increase your risk of contracting COVID-19. Please complete a separate waiver for each child for each sport of participation.

READ CAREFULLY BEFORE SIGNING – INITIAL EACH PARAGRAPH By signing this agreement,  I  acknowledge the  contagious nature  of  COVID-19  and voluntarily assume  the risk  that  I may  be  exposed  to  or  infected  by  COVID-19 by participation; 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 Lanier Soccer Association activities and events may result from the actions, omissions, or negligence of myself and

others, including, but not limited to, Lanier Soccer Association Members, volunteers,  coaches,  program  participants and their families.
I voluntarily  agree to  assume  all  of  the  foregoing  risks  and  accept  sole  responsibility  for  any  injury  to
myself (including, but not limited to, personal injury, disability, and death, illness, damage, loss, claim, liability, or expense), of any kind, that I may experience or incur in connection with my participation with Lanier Soccer Association. On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless Lanier Soccer Association, its board members, volunteers, coaches, 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 Lanier Soccer Association , its board members, volunteers, coaches, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation at Lanier Soccer Association.

I  represent  that  I  have  adequate  insurance  to  cover  any  injury  or  illness  I  may  suffer  or  cause  while

participating in this activity, or else I agree to bear the costs of such injury or illness myself. I further represent that I have no medical or physical condition which could interfere with my safety in this activity, or else I am willing to assume–  and  bear the costs of  – all  risks that may be created, directly or indirectly, by any such condition.

By signing  this document, I  agree  that  if  I  am  exposed  or  infected  by COVID-19  during  my participation
in this activity, then I may be found  by a court  of law to have waived my right  to maintain a lawsuit  against  the parties being released on the basis of any claim for negligence.

I have had sufficient time to read this entire document and,  should I  choose to do so,  consult  with legal

counsel prior to signing. I have read and understood this document and I agree to be bound by its terms.

 I have signed a separate general waiver of liability connected to my participation with Lanier Soccer Association

during the initial registration process and I agree that the terms of that waiver are wholly incorporated into this document and that the terms of this document are incorporated into the separate general waiver.

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Referee First and Last Name *
Email *
Phone Number *
Phone Number *
PARENT OR GUARDIAN ADDITIONAL AGREEMENT (Must be completed for participants under the age of 18) Please type your name and last name
I allow and being permitted to participate in this activity,I further agree to indemnify and hold harmless Releases from any claims alleging negligence which are brought by or on behalf of minor or are in any way connected with such participation by minor. *
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