COVID-19 Acknowledgment of Risk and Release for CMSA Program Participants and Visitors
As a condition of participating in the Harvard's CMSA seminars, conferences, or other events  (the “Program”), you accept and agree to the following:

1. You may not enter upon “Harvard Premises,” which include any buildings or facilities on any Harvard  University campus and any off-campus interior spaces leased or procured by Harvard for Program events,  unless you meet all of the following requirements:

•You are not currently experiencing or displaying any known symptom of COVID-19. • You have not in the previous 14 days tested positive for COVID-19 or experienced or displayed  any known symptom of COVID-19.

• You have not in the previous 14 days had close contact with anyone who is either confirmed or  suspected of being infected with COVID-19, including anyone who was experiencing or  displaying any known symptom of COVID-19.

• You either are fully vaccinated against COVID-19 using a vaccine and booster (if you are not yet  eligible to receive the booster, your deadline will be 30 days after you become eligible) authorized  by the FDA or WHO or are eligible for an exemption based on a medical contraindication or  firmly held religious belief.

• You will comply with all applicable health and safety requirements imposed by federal, state, and  local authorities and Harvard University to limit the spread of COVID-19, as they may be adjusted  from time to time in response to current conditions. These may include travel restrictions, self isolation/ quarantine requirements, and lockdown orders, and you will abide by any such  applicable restrictions, even if they prevent you from conducting activities that may have been  planned as part of the Program.

• You have read, you understand, and you will comply with all masking and social distancing  requirements, posted or otherwise provided by the Math Department for the Program.
• You have taken a PCR or rapid test and received a negative result within 48 hours before arrival to  campus.

• You are expected to report a positive COVID-19 test result or clinician diagnosis to HUHS via  email immediately if you have been on campus within 48 hours of symptom onset or receive a  positive COVID-19 test result.

Harvard reserves the right to impose different or additional requirements as it deems appropriate from time  to time.  

A list of known COVID-19 symptoms is included at the end of this form.*

2. Although Harvard University has taken steps to comply with federal and state safety standards designed  to reduce the risk of COVID-19 infection, the University cannot guarantee that an individual entering  upon Harvard Premises or participating in the Program will not contract COVID-19. Nor is Harvard in a  position to know if you are or will be physically near to a person infected with COVID-19. Accordingly, in  entering upon Harvard Premises or participating in the Program, you recognize that you may be subjected
to potential risks of infection, illness, injury, and even death from COVID-19. You have made your own  investigation of these risks, understand these risks, and assume these risks knowingly and willingly.

3. To the maximum extent permitted by law, you release Harvard, its current and former members of its  governing boards, officers, faculty, staff, representatives, volunteers, employees, fellows, students, other  trainees and agents, and their respective heirs and assigns, from any and all claims, losses, expenses,  damages, or liabilities which you may incur or suffer, arising out of or related to your contracting COVID 19 while participating in the Program (including periods in transit to or from Program events) and  resulting from any cause.  

4. This agreement shall be governed by the laws of the Commonwealth of Massachusetts (excluding its  conflict of laws principles), which shall be the forum for any lawsuits filed under or incident to this  document.
I have carefully read the COVID-19 Acknowledgement of Risk and Release form before signing it, am in  compliance with all conditions for entering upon Harvard Premises, and will comply with all rules while on  those premises.

I have carefully read the COVID-19 Acknowledgement of Risk and Release form before signing it, am in  compliance with all conditions for entering upon Harvard Premises, and will comply with all rules while on  those premises.


*Known COVID-19 symptoms include: fever, chills, or feeling feverish; new cough (not related to  chronic condition); shortness of breath or difficulty breathing; new fatigue; muscle or body aches;  new headache; new loss of taste or smell; sore throat; new nasal congestion or new runny nose (not  related to seasonal allergies); nausea or vomiting; diarrhea.
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