Fairfax Democrats Ride to the Polls Program
Complete this form to request a ride to the polls or to be a driver for voters needing rides.
Waiver of Liability Relating to Coronavirus/COVID-19
COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is reported to be extremely contagious. The virus is believed to spread from person-to-person contact and/or by contact with contaminated surfaces and objects, and even possibly in the air.
Some people with COVID-19 show no signs or symptoms and therefore can spread the disease. The exact methods of spread and contraction are unknown, and there is no known treatment, cure, or vaccine for COVID-19. Evidence has shown that COVID-19 can cause serious and potentially life threatening illness and even death.
FCDC cannot prevent you from becoming exposed to, contracting, or spreading COVID-19 while utilizing FCDC’s Ride to the Polls. While we take appropriate safety measure, the disease may still be present. Therefore, if you choose to use FCDC’s Ride to the Polls, you may be exposing yourself to and/or increasing your risk of contracting or spreading COVID-19.
ASSUMPTION OF RISK: I have read and understood the above warning concerning COVID-19. I hereby choose to accept the risk of contracting COVID-19 for myself to utilize FCDC’s Ride to the Polls. These services are of such value to me that I accept the risk of being exposed to, contracting, and/or spreading COVID-19 in order to utilize FCDC’s Ride to the Polls in person rather than arranging for an alternative method of transportation.
WAIVER OF LAWSUIT/LIABILITY: I hereby forever release and waive my right to bring suit against FCDC, its officers, directors, managers, officials, trustees, agents, employees, or other representatives in connection with exposure, infection, and/or spread of COVID-19 related to FCDC’s Ride to the Polls’ services and premises. I understand that this waiver means I give up my right to bring any claims including for personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen.
CHOICE OF LAW: I understand and agree that the law of the State of Virginia will apply to this contract.
BY CONTINUING ON THIS WEBSITE, I CERTIFY THAT I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS RELEASE, AND FREELY AND KNOWINGLY ASSUME THE RISK AND WAIVE MY RIGHTS CONCERNING LIABILITY AS DESCRIBED ABOVE.
I accept the terms and conditions as laid out in the above Waiver of Liability.
Requesting a ride (passenger)
Willing to drive (driver)
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