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. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.
The Winchester Jiujitsu Academy (WJJA) has put in place preventative measures to reduce the spread of COVID-19; however, WJJA cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending the WJJA could increase your risk and your child(ren)’s risk of contracting COVID-19.
By signing this agreement, I {name}, acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending the WJJA 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 the WJJA may result from the actions, omissions, or negligence of myself and others, including, but not limited to, WJJA employees, program participants, and their families.
I, {name}, voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at the WJJA or participation in WJJA programming (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the WJJA,
its employees, 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 the WJJA, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any WJJA program.
I, {name}, affirm that I have read and understood the above, have not had Covid-19, nor been in close proximity to anyone currently displaying symptoms of fever or Covid-19. Furthermore, if I develop symptoms or come into contact with a known carrier, I will alert the WJJA and not attend classes for a minimum of 14 days.
Name and signature of Member/Guardian: {name}
Date: {sign_date}