Omulu SF Peninsula Capoeira - COVID-19 Liability Waiver (August 10, 2021 CA Re-Opening)
This liability waiver and release extends to all students and all Omulu SF Peninsula Capoeira affiliations. Please read and fill out the following form before attending classes.
Sign in to Google to save your progress. Learn more
I - the participant, or parent/guardian of minor participant: -Acknowledge the contagious nature of the COVID-19 virus and respect that Daniel Rosse Jr. and Omulu SF Peninsula Capoeira adhere to the CDC recommendations on COVID-19 guidelines. -Acknowledge that Daniel Rosse Jr. and SF Peninsula Capoeira, have put in place preventative measures to help reduce the spread of the COVID-19 virus, to the best of their abilities. -Understand that the risk of becoming exposed to and/or infected by the COVID-19 virus may result from the actions, omissions, or negligence of myself and others, including, but not limited to other students, parents and visitors. -Acknowledge that I can increase my risk of exposure to COVID-19 by participating in services provided at the studio, or any SF Peninsula Capoeira events. - Acknowledge that I must comply with all set procedures to help reduce the spread while in attendance at the studio and any SF Peninsula Capoeira events. *
Can attest that: I am not experiencing any symptoms of illness such as cough, shortness of breath, difficulty breathing, fever, chills, muscle pain, headache, sore throat, or new loss of taste or smell. - I do not believe I have been exposed to someone with a suspected and/or confirmed case of COVID-19. - I have not been diagnosed with COVID-19 by state or local public health authorities.I am following all CDC recommended guidelines, including limiting any purposeful exposure to COVID-19. -Am following the CDC guidelines for COVID-19 for vaccinated and unvaccinated individuals. Hereby release and exempt Daniel Rosse Jr. and SF Peninsula Capoeira from any harm, and waive any legals claims from demands, damages, costs, expenses and compensation for any COVID-19 related health issues to myself for any services received at the studio or any SF Peninsula Capoeira events. -I have read the above COVID-19 Liability Waiver and fully understand its contents, and by signing this agreement consent to the terms and conditions stated above. *
By digitally signing (typing in your full name) you agree to the waiver prior to you or your child taking classes. Type your full name below and child's name (if they are taking classes) *
Omulu SF Peninsula Capoeira COVID-19 Re-Opening Guidelines MASKS: At this time we are asking for all students to wear masks regardless of vaccination status. We will reevaluate as we reopen and as we monitor the current case numbers and data. STUDIO: Only students participating in class or events are allowed inside the studio until further notice STUDENTS: if you're feeling sick please stay home - Please minimize items brought to the studio (backpacks, clothing, hats, etc..). Please try to come prepared for class in your full uniformAll students must follow the CDC guidelines for all outdoor classes and events related to SF Peninsula Capoeira *
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy