Osher Marin JCC (JCC) Adult Participant Waiver, Release, Indemnification of All Claims & Covenant Not to Sue
Last Name *
First Name *
Waiver of Liability and Assumption of Risk
I hereby acknowledge and agree that activities in the JCC can lead to serious physical injuries. Participant acknowledges and agrees that he/she is voluntarily assuming these risks and solely responsible for his/her safe and responsible use of the Facilities, whether or not supervised by JCC representative. Participant hereby expressly assumes the risk that he/she may suffer injury as a result of his/her use of Facilities or equipment or participation in JCC activities.

In consideration of my participation in any and all programs and services of the JCC I, agrees for myself and on behalf of my heirs, representatives, successors and assigns ("participant parties") that the JCC, including its owners, partners, members, directors, officers, employees and agents ("JCC parties") will not be liable for any damages or injuries participant parties may suffer in or about JCC. Participant agrees on his/her behalf that none of them will make any claim against, sue or attach the property of any JCC party or affiliate thereof. Participant also agrees that JCC will not be liable for any loss, theft or damage to Participant's personal property in or about the Facilities including any personal property kept in a locker at the JCC. I further certify that I am in good health and that I have no conditions or impairments which would preclude my safe participation in JCC activities.
Coronavirus / COVID-19 Warning & Disclaimeritle
Coronavirus, COVID-19 is an extremely contagious virus that spreads easily through person-to-person contact. Federal and state authorities recommend social distancing and masks as a means to prevent the spread of the virus. COVID-19 can lead to severe illness, personal injury, permanent disability, and death. Participating in JCC programs or accessing JCC facilities could increase the risk of contracting COVID-19. JCC in no way warrants that COVID-19 infection will not occur through participation in our programs or accessing our facilities.

CDC and other governmental guidelines are continually being updated regarding individuals who may be more susceptible to contracting the virus or who may suffer more severe consequences as a result if having the virus. I understand that I and/or other members of my family may have underlying conditions that place them at a higher risk of serious consequences from contracting the virus and I willingly consent and agree to participate with full knowledge and understanding of this increased risk.
I further certify that my date of birth is *
MM
/
DD
/
YYYY
My present age is *
IN WITNESS WHEREOF, this instrument is duly executed this date *
MM
/
DD
/
YYYY
Participant Signature *
ELECTRONIC SIGNATURE CONSENT *
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy