Common use of Liability Waiver Clause in Contracts

Liability Waiver. By signing this agreement, I acknowledge the contagious nature of COVID-19 and that my child(ren) and/or I may be exposed to or infected by COVID-19 by participating in in-person Parish and Faith Formation activities, and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 at the above-named Parish may result from the actions, omissions, or negligence of myself, my child(ren) or others, including, but not limited to Diocesan or Parish administrators, employees, volunteers, and other program participants and their families. I further agree on behalf of myself and/or my child(ren) named herein, and our respective heirs, successors, and assigns, to fully and forever release, defend, indemnify, and hold harmless the Catholic Diocese of Arlington, the named Parish, their clergy, administrators, employees, agents, members and volunteers ("Indemnitees") from any and all claims, damages, demands, and causes of action, present or future, known or unknown, anticipated or unanticipated, in any way related to exposure to COVID-19 while participating in Parish and Faith Formation activities, including but not limited to any claims of negligent exposure. This includes claims that arise from my own and others’ acts, actions, activities and/or omissions, excepting only those which arise solely from the gross negligence, recklessness or intentional torts of Indemnitees. I will defend and indemnify Indemnitees with respect to any released claim, including but not limited to damages, costs and attorney’s fees. Responsibility for Health Screening By execution of this Statement, I affirm that my or my child(xxx)’s presence at named Parish on any day constitutes an affirmative representation on my part that I/we have performed the required health screening below and affirm that the responses to all questions are NO. SCREENING QUESTIONS “YES or NO, neither I nor my child(xxx) have any of the following:” • A fever of 100.4°F. (38°C.) or higher or a sense of having a fever during the past 72 hours • New or unexpected cough that cannot be attributed to another health condition • New shortness of breath or difficulty breathing that cannot be attributed to another health condition • New chills that cannot be attributed to another health condition • A new sore throat that cannot be attributed to another health condition • New muscle aches that cannot be attributed to another health condition or specific activity (such as physical exercise) • New loss of taste or smell • Nausea, vomiting or diarrhea • Currently living with a person who has exhibited symptoms of COVID-19 or is currently under quarantine due to close contact with a person suspected or confirmed to have COVID-19 “YES or NO, in the past 14 days, neither I nor my child(xxx) have done any of the following:” • Cared for or had other close contact with a person suspected or confirmed to have COVID-19 • Travelled internationally I understand that on any day when anyone in our household answers YES to any of the required health screening questions above, I and/or my child(ren) are not permitted to participate in in-person Parish and Faith Formation activities.

Liability Waiver. By signing this agreement, I acknowledge the contagious nature of COVID-19 and that my child(ren) and/or and/ or I may be exposed to or infected by COVID-19 by participating in in-person Parish and Faith Formation Youth Ministry activities, and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 at the above-named Parish may result from the actions, omissions, or negligence of myself, my child(ren) or others, including, but not limited to Diocesan or Parish administrators, employees, volunteers, and other program participants and their families. I further agree on behalf of myself and/or my child(renchild(xxx) named herein, and our respective heirs, successors, and assigns, to fully and forever to release, defend, indemnify, and hold harmless the Catholic Diocese of Arlington, the named ParishSchool, their clergy, administrators, employees, agents, members and volunteers ("Indemnitees") from any and all claims, damages, demands, and causes of action, present or future, known or unknown, anticipated or unanticipated, in any way related to exposure to COVID-19 while participating in Parish and Faith Formation Youth Ministry activities, including but not limited to any claims of negligent exposure. This includes claims that arise from my own and others’ acts, actions, activities and/or omissions, excepting only those which that arise solely from the gross negligence, recklessness or intentional torts of Indemnitees, and those that are both (a) not asserted by our child or family or any member thereof, and (b) not alleged to arise from our acts or omissions. With respect to claims alleged to arise from our acts or omissions, our agreement to defend, indemnify and hold harmless the Indemnitees shall be effective only in the event that I, my child, or a member of our family is determined to be liable for such acts or omissions under applicable law, or by agreement. I will defend and indemnify Indemnitees with respect to any released claim, including but not limited to damages, costs and attorney’s fees. Responsibility for Health Screening By execution of this Statement, I affirm that my or my child(xxx)’s presence at named Parish on any day constitutes an affirmative representation on my part that I/we have performed the required all health screening below and affirm that steps required by the responses to all questions are NOParish for attendance or participation in Youth Ministry activities. SCREENING QUESTIONS “YES or NO, neither I nor my child(xxx) have any of the following:” • A fever of 100.4°F. (38°C.) or higher or a sense of having a fever during the past 72 hours • New or unexpected cough that cannot be attributed to another health condition • New shortness of breath or difficulty breathing that cannot be attributed to another health condition • New chills that cannot be attributed to another health condition • A new sore throat that cannot be attributed to another health condition • New muscle aches that cannot be attributed to another health condition or specific activity (such as physical exercise) • New loss of taste or smell • Nausea, vomiting or diarrhea • Currently living with a person who has exhibited symptoms of COVID-19 or is currently under quarantine due to close contact with a person suspected or confirmed to have COVID-19 “YES or NO, in the past 14 days, neither I nor my child(xxx) have done any of the following:” • Cared for or had other close contact with a person suspected or confirmed to have COVID-19 • Travelled internationally I understand that on any day when anyone in our household answers YES to any of my child(ren) does not pass the required health screening (which may include questions aboverelating to other members of the household as well as my child(ren)), I and/or my child(ren) are not permitted to participate in in-person Youth Ministry activities. Need to Inform and Quarantine I understand, in the event that I/my child is suspected or confirmed positive with COVID-19 or has come in close contact with a person suspected or confirmed positive with COVID-19, I/my child will need to follow the CDC’s guidance for isolation or quarantine as implemented by the Virginia Department of Health and local health departments. Information is available at xxx.xxx.xxx. I agree to inform the Parish administration as soon as possible, but no later than one (1) business day, after learning of my/my child’s suspected or confirmed positive case of COVID-19 and/or the need to quarantine due to close contact with a person suspected or confirmed positive for COVID-19. I understand that I/my child may not return to in-person Youth Ministry activities until approved by Parish Administration. Approval will be based on confirmation by the local health department that the CDC's criteria to discontinue home isolation or quarantine has been met. Authorization and Faith Formation activities.Informed Consent I hereby authorize the Parish to enforce such other reasonable measures and directives as may be deemed necessary by the Xxxxxx of the Diocese of Arlington, its Office of Youth, Campus, and Young Adult Ministries, or the Parish leadership. I further understand that, in the event that it becomes necessary that events or programs should be canceled or administered via electronic media, I will not be entitled to a refund of any of my fees. By execution of this Agreement, I understand and agree to the foregoing terms and conditions. Student Signature (if 18 or older):

Liability Waiver. By signing this agreement, I acknowledge the contagious nature of COVID-19 and that my child(ren) and/or I may be exposed to or infected by COVID-19 by participating in in-person Parish and Faith Formation activities, and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 at the above-named Parish may result from the actions, omissions, or negligence of myself, my child(ren) or others, including, but not limited to Diocesan or Parish administrators, employees, volunteers, and other program participants and their families. I further agree on behalf of myself and/or my child(ren) named herein, and our respective heirs, successors, and assigns, to fully and forever release, defend, indemnify, and hold harmless the Catholic Diocese of Arlington, the named Parish, their clergy, administrators, employees, agents, members and volunteers ("Indemnitees") from any and all claims, damages, demands, and causes of action, present or future, known or unknown, anticipated or unanticipated, in any way related to exposure to COVID-19 while participating in Parish and Faith Formation activities, including but not limited to any claims of negligent exposure. This includes claims that arise from my own and others’ acts, actions, activities and/or omissions, excepting only those which arise solely from the gross negligence, recklessness or intentional torts of Indemnitees. I will defend and indemnify Indemnitees with respect to any released claim, including but not limited to damages, costs and attorney’s fees. Responsibility for Health Screening By execution of this Statement, I affirm that my or my child(xxx)’s presence at named Parish on any day constitutes an affirmative representation on my part that I/we have performed the required health screening below and affirm that the responses to all questions are NO. SCREENING QUESTIONS ““ YES or NO, neither I nor my child(xxx) have any of the following:” • A fever of 100.4°F. (38°C.) or higher or a sense of having a fever during the past 72 hours • New or unexpected cough that cannot be attributed to another health condition • New shortness of breath or difficulty breathing that cannot be attributed to another health condition • New chills that cannot be attributed to another health condition • A new sore throat that cannot be attributed to another health condition • New muscle aches that cannot be attributed to another health condition or specific activity (such as physical exercise) • New loss of taste or smell • Nausea, vomiting or diarrhea • Currently living with a person who has exhibited symptoms of COVID-19 or is currently under quarantine due to close contact with a person suspected or confirmed to have COVID-19 ““ YES or NO, in the past 14 days, neither I nor my child(xxx) have done any of the following:” • Cared for or had other close contact with a person suspected or confirmed to have COVID-19 • Travelled internationally I understand that on any day when anyone in our household answers YES to any of the required health screening questions above, I and/or my child(ren) are not permitted to participate in in-person Parish and Faith Formation activities.

Liability Waiver. By signing this agreement, I acknowledge the contagious nature of COVID-19 and that my child(ren) and/or and/ or I may be exposed to or infected by COVID-19 by participating in in-person Parish and Faith Formation Youth Ministry activities, and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 at the above-named Parish or Diocesan Event may result from the actions, omissions, or negligence of myself, my child(ren) or others, including, but not limited to Diocesan or Parish administrators, employees, volunteers, and other program participants and their families. I further agree on behalf of myself and/or my child(renchild(xxx) named herein, and our respective heirs, successors, and assigns, to fully and forever to release, defend, indemnify, and hold harmless the Catholic Diocese of Arlington, the named Parishparish, their clergy, administrators, employees, agents, members and volunteers ("Indemnitees") from any and all claims, damages, demands, and causes of action, present or future, known or unknown, anticipated or unanticipated, in any way related to exposure to COVID-19 while participating in Parish and Faith Formation Youth Ministry activities, including but not limited to any claims of negligent exposure. This includes claims that arise from my own and others’ acts, actions, activities and/or omissions, excepting only those which that arise solely from the gross negligence, recklessness or intentional torts of Indemnitees, and those that are both (a) not asserted by our child or family or any member thereof, and (b) not alleged to arise from our acts or omissions. With respect to claims alleged to arise from our acts or omissions, our agreement to defend, indemnify and hold harmless the Indemnitees shall be effective only in the event that I, my child, or a member of our family is determined to be liable for such acts or omissions under applicable law, or by agreement. I will defend and indemnify Indemnitees with respect to any released claim, including but not limited to damages, costs and attorney’s fees. Responsibility for Health Screening By execution of this Statement, I affirm that my or my child(xxx)’s presence at named Parish or a Diocesan Event on any day constitutes an affirmative representation on my part that I/we have performed the required all health screening below and affirm that steps required by the responses to all questions are NOParish/Diocese for attendance or participation in Youth Ministry activities. SCREENING QUESTIONS “YES or NO, neither I nor my child(xxx) have any of the following:” • A fever of 100.4°F. (38°C.) or higher or a sense of having a fever during the past 72 hours • New or unexpected cough that cannot be attributed to another health condition • New shortness of breath or difficulty breathing that cannot be attributed to another health condition • New chills that cannot be attributed to another health condition • A new sore throat that cannot be attributed to another health condition • New muscle aches that cannot be attributed to another health condition or specific activity (such as physical exercise) • New loss of taste or smell • Nausea, vomiting or diarrhea • Currently living with a person who has exhibited symptoms of COVID-19 or is currently under quarantine due to close contact with a person suspected or confirmed to have COVID-19 “YES or NO, in the past 14 days, neither I nor my child(xxx) have done any of the following:” • Cared for or had other close contact with a person suspected or confirmed to have COVID-19 • Travelled internationally I understand that on any day when anyone in our household answers YES to any of my child(ren) does not pass the required health screening (which may include questions aboverelating to other members of the household as well as my child(ren)), I and/or my child(ren) are not permitted to participate in in-person Youth Ministry activities. Need to Inform and Quarantine I understand, in the event that I/my child is suspected or confirmed positive with COVID-19 or has come in close contact with a person suspected or confirmed positive with COVID-19, I/my child will need to follow the CDC’s guidance for isolation or quarantine as implemented by the Virginia Department of Health and local health departments. Information is available at xxx.xxx.xxx. I agree to inform the Parish administration as soon as possible, but no later than one (1) business day, after learning of my/my child’s suspected or confirmed positive case of COVID-19 and/or the need to quarantine due to close contact with a person suspected or confirmed positive for COVID-19. I understand that I/my child may not return to in-person Youth Ministry activities until approved by Parish Administration, or as applicable, by Diocesan Staff. Authorization and Faith Formation activities.Informed Consent I hereby authorize the Parish to enforce such other reasonable measures and directives as may be deemed necessary by the Xxxxxx of the Diocese of Arlington, its Office of Youth, Campus, and Young Adult Ministries, or the Parish leadership. I further understand that, in the event that it becomes necessary that events or programs should be canceled or administered via electronic media, I will not be entitled to a refund of any of my fees. By execution of this Agreement, I understand and agree to the foregoing terms and conditions. Student Signature (if 18 or older): Parent/Legal Guardian Signature:

Liability Waiver. By signing this agreement, I acknowledge the contagious nature of COVID-19 and that my child(ren) and/or and/ or I may be exposed to or infected by COVID-19 by participating in in-person Parish and Faith Formation Youth Ministry activities, and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 at the above-named Parish or Diocesan Event may result from the actions, omissions, or negligence of myself, my child(ren) or others, including, but not limited to Diocesan or Parish administrators, employees, volunteers, and other program participants and their families. I further agree on behalf of myself and/or my child(renchild(xxx) named herein, and our respective heirs, successors, and assigns, to fully and forever to release, defend, indemnify, and hold harmless the Catholic Diocese of Arlington, the named Parishparish, their clergy, administrators, employees, agents, members and volunteers ("Indemnitees") from any and all claims, damages, demands, and causes of action, present or future, known or unknown, anticipated or unanticipated, in any way related to exposure to COVID-19 while participating in Parish and Faith Formation Youth Ministry activities, including but not limited to any claims of negligent exposure. This includes claims that arise from my own and others’ acts, actions, activities and/or omissions, excepting only those which that arise solely from the gross negligence, recklessness or intentional torts of Indemnitees, and those that are both (a) not asserted by our child or family or any member thereof, and (b) not alleged to arise from our acts or omissions. With respect to claims alleged to arise from our acts or omissions, our agreement to defend, indemnify and hold harmless the Indemnitees shall be effective only in the event that I, my child, or a member of our family is determined to be liable for such acts or omissions under applicable law, or by agreement. I will defend and indemnify Indemnitees with respect to any released claim, including but not limited to damages, costs and attorney’s fees. Responsibility for Health Screening By execution of this Statement, I affirm that my or my child(xxx)’s presence at named Parish or a Diocesan Event on any day constitutes an affirmative representation on my part that I/we have performed the required all health screening below and affirm that steps required by the responses to all questions are NOParish/Diocese for attendance or participation in Youth Ministry activities. SCREENING QUESTIONS “YES or NO, neither I nor my child(xxx) have any of the following:” • A fever of 100.4°F. (38°C.) or higher or a sense of having a fever during the past 72 hours • New or unexpected cough that cannot be attributed to another health condition • New shortness of breath or difficulty breathing that cannot be attributed to another health condition • New chills that cannot be attributed to another health condition • A new sore throat that cannot be attributed to another health condition • New muscle aches that cannot be attributed to another health condition or specific activity (such as physical exercise) • New loss of taste or smell • Nausea, vomiting or diarrhea • Currently living with a person who has exhibited symptoms of COVID-19 or is currently under quarantine due to close contact with a person suspected or confirmed to have COVID-19 “YES or NO, in the past 14 days, neither I nor my child(xxx) have done any of the following:” • Cared for or had other close contact with a person suspected or confirmed to have COVID-19 • Travelled internationally I understand that on any day when anyone in our household answers YES to any of my child(ren) does not pass the required health screening (which may include questions aboverelating to other members of the household as well as my child(ren)), I and/or my child(ren) are not permitted to participate in in-person Youth Ministry activities. Need to Inform and Quarantine I understand, in the event that I/my child is suspected or confirmed positive with COVID-19 or has come in close contact with a person suspected or confirmed positive with COVID-19, I/my child will need to follow the CDC’s guidance for isolation or quarantine as implemented by the Virginia Department of Health and local health departments. Information is available at xxx.xxx.xxx. I agree to inform the Parish administration as soon as possible, but no later than one (1) business day, after learning of my/my child’s suspected or confirmed positive case of COVID-19 and/or the need to quarantine due to close contact with a person suspected or confirmed positive for COVID-19. I understand that I/my child may not return to in-person Youth Ministry activities until approved by Parish Administration, or as applicable, by Diocesan Staff. Authorization and Faith Formation activitiesInformed Consent I hereby authorize the Parish to enforce such other reasonable measures and directives as may be deemed necessary by the Xxxxxx of the Diocese of Arlington, its Office of Youth, Campus, and Young Adult Ministries, or the Parish leadership. I further understand that, in the event that it becomes necessary that events or programs should be canceled or administered via electronic media, I will not be entitled to a refund of any of my fees. By execution of this Agreement, I understand and agree to the foregoing terms and conditions. Student Signature (if 18 or older): Parent/Legal Guardian Signature: Date: ACUERDO OBLIGATORIO‌ PARA PARTICIPANTES DE LA PASTORAL JUVENIL DE LA DIÓCESIS DE ARLINGTON NOMBRE DEL PARTICIPANTE: NOMBRE DE LA PARROQUIA: NOMBRE DEL PADRE/ TUTOR LEGAL: Asunción de riesgos El nuevo coronavirus y sus variantes que causan el COVID-19 ha sido declarado pandemia mundial y es contagioso. Para poder continuar con la participación presencial, la parroquia mencionada arriba (“Parroquia”) y la Diócesis Católica de Arlington han establecido medidas de salud y seguridad esenciales. La Parroquia/ Diócesis han puesto en práctica medidas preventivas y normas de conducta para reducir la probabilidad de contagio del COVID-19 en las actividades de la Pastoral Juvenil. Estas medidas y normas podrán ser actualizadas durante el año pastoral. No obstante, aun con la implementación de estos protocolos de salud y seguridad, ni la Parroquia ni la Diócesis Católica de Arlington puede garantizar que su hijo no se contagie del COVID-19. La asistencia a la Parroquia/ Diócesis y la participación en las actividades de Pastoral Juvenil podría incrementar el riesgo de que usted y/o su hijo se contagien del COVID-19. Toda interacción con otras personas puede implicar el riesgo de exponerse y contraer una enfermedad contagiosa, como el COVID-19. Entiendo que las actividades de la Pastoral Juvenil no son obligatorias. Al enviar a mi hijo a las actividades de la Pastoral Juvenil en persona, doy mi consentimiento informado para que mi hijo o yo participemos y asumamos la responsabilidad por los riesgos mencionados. Mi hijo y yo acordamos voluntariamente cumplir con los protocolos de salud y seguridad establecidos por la Parroquia/Diócesis, incluidas las futuras modificaciones de dichos protocolos, y xxxxx todas las precauciones adicionales y necesarias para protegernos de cualquier enfermedad contagiosa dentro de las instalaciones de la Parroquia o localización de un evento Diocesano, no solo para nuestro propio beneficio sino para beneficio de las xxxxx personas con las que podamos tener contacto. Acordamos que, si observamos algún objeto, práctica o procedimiento que creamos peligroso dentro de las instalaciones de la Parroquia o localización de un evento Diocesano, nos alejaremos de dicho peligro y lo comunicaremos de inmediato a la administración de la Parroquia o Diócesis. Descargo de responsabilidad Firmando este acuerdo, reconozco que el COVID-19 es contagioso por naturaleza y que mi hijo y/o yo podríamos exponernos o contagiarnos el COVID-19 al participar de las actividades presenciales de la Pastoral Juvenil, y que dicha exposición o contagio podría provocarnos una lesión personal, una enfermedad, una discapacidad permanente y/o la muerte. Entiendo que mi hijo y yo corremos el riesgo de exponernos o contagiarnos el COVID-19 en la Parroquia o evento Diocesano mencionada arriba por las acciones, omisiones o negligencia nuestra o de terceros, incluidos entre otros, los administradores, empleados, voluntarios y otros alumnos/participantes de los programas de la Diócesis o la Parroquia, y sus respectivas familias. Acuerdo además, en nombre propio y en nombre de mi hijo mencionado en el presente y de nuestros respectivos herederos, sucesores y cesionarios, liberar, defender, indemnizar y eximir por completo y para siempre a la Diócesis Católica de Arlington, la Parroquia, su clero, administradores, empleados, agentes, miembros y voluntarios ("Indemnizados") de cualquier reclamo, daño, demanda y pretensión legal presente o futura, conocida o desconocida, prevista o imprevista, relacionada con la exposición al COVID-19 durante la participación en las actividades de la Pastoral Juvenil, incluidas las demandas por exposición culposa, entre otras. Esto incluye a las demandas que xxxxxx xxxx consecuencia de actos, acciones, actividades y/u omisiones propias o de terceros, solo con la excepción de aquellas que xxxxxx xxxx consecuencia de la culpa grave, negligencia o actos intencionales de los Indemnizados, y aquellas que (a) no hayan sido aseveradas por nuestro hijo o familia y (b) no se presuman ocasionadas por nuestras acciones u omisiones. Con respecto a las demandas presuntamente ocasionadas por nuestras acciones u omisiones, nuestro acuerdo de defender, indemnizar y eximir a los Indemnizados será válido solo en el caso de que mi hijo yo o un miembro de nuestra familia seamos considerados responsables de dichas acciones u omisiones en virtud de xx xxx aplicable o por acuerdo. Defenderé e indemnizaré a los Indemnizados con respecto a los reclamos eximidos, incluidos los xxxxx y perjuicios, las costas legales y los honorarios de los abogados. Responsabilidad por el control de la salud Firmando esta Declaración, afirmo que la presencia de mi hijo en la Parroquia o evento Diocesano constituye una declaración afirmativa de mi parte de que hemos realizado los controles de salud que exige la Parroquia/Diócesis para poder asistir o participar en las actividades de la Pastoral Juvenil. Entiendo que, si algún día mi hijo no pasa el control de salud obligatorio (que puede incluir preguntas relacionadas con otros miembros del hogar y con mis hijos, ni mi hijo ni yo podremos participar en las actividades presenciales de la Pastoral Juvenil.

Liability Waiver. By signing this agreement, I acknowledge the contagious nature of COVID-19 and that my child(ren) and/or and/ or I may be exposed to or infected by COVID-19 by participating in in-person Parish and Faith Formation Youth Ministry activities, and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 at the above-named Parish may result from the actions, omissions, or negligence of myself, my child(ren) or others, including, but not limited to Diocesan or Parish administrators, employees, volunteers, and other program participants and their families. I further agree on behalf of myself and/or my child(renchild(xxx) named herein, and our respective heirs, successors, and assigns, to fully and forever to release, defend, indemnify, and hold harmless the Catholic Diocese of Arlington, the named Parishparish, their clergy, administrators, employees, agents, members and volunteers ("Indemnitees") from any and all claims, damages, demands, and causes of action, present or future, known or unknown, anticipated or unanticipated, in any way related to exposure to COVID-19 while participating in Parish and Faith Formation Youth Ministry activities, including but not limited to any claims of negligent exposure. This includes claims that arise from my own and others’ acts, actions, activities and/or omissions, excepting only those which that arise solely from the gross negligence, recklessness or intentional torts of Indemnitees, and those that are both (a) not asserted by our child or family or any member thereof, and (b) not alleged to arise from our acts or omissions. With respect to claims alleged to arise from our acts or omissions, our agreement to defend, indemnify and hold harmless the Indemnitees shall be effective only in the event that I, my child, or a member of our family is determined to be liable for such acts or omissions under applicable law, or by agreement. I will defend and indemnify Indemnitees with respect to any released claim, including but not limited to damages, costs and attorney’s fees. Responsibility for Health Screening By execution of this Statement, I affirm that my or my child(xxx)’s presence at named Parish on any day constitutes an affirmative representation on my part that I/we have performed the required all health screening below and affirm that steps required by the responses to all questions are NOParish for attendance or participation in Youth Ministry activities. SCREENING QUESTIONS “YES or NO, neither I nor my child(xxx) have any of the following:” • A fever of 100.4°F. (38°C.) or higher or a sense of having a fever during the past 72 hours • New or unexpected cough that cannot be attributed to another health condition • New shortness of breath or difficulty breathing that cannot be attributed to another health condition • New chills that cannot be attributed to another health condition • A new sore throat that cannot be attributed to another health condition • New muscle aches that cannot be attributed to another health condition or specific activity (such as physical exercise) • New loss of taste or smell • Nausea, vomiting or diarrhea • Currently living with a person who has exhibited symptoms of COVID-19 or is currently under quarantine due to close contact with a person suspected or confirmed to have COVID-19 “YES or NO, in the past 14 days, neither I nor my child(xxx) have done any of the following:” • Cared for or had other close contact with a person suspected or confirmed to have COVID-19 • Travelled internationally I understand that on any day when anyone in our household answers YES to any of my child(ren) does not pass the required health screening (which may include questions aboverelating to other members of the household as well as my child(ren)), I and/or my child(ren) are not permitted to participate in in-person Youth Ministry activities. Need to Inform and Quarantine I understand, in the event that I/my child is suspected or confirmed positive with COVID-19 or has come in close contact with a person suspected or confirmed positive with COVID-19, I/my child will need to follow the CDC’s guidance for isolation or quarantine as implemented by the Virginia Department of Health and local health departments. Information is available at xxx.xxx.xxx. I agree to inform the Parish administration as soon as possible, but no later than one (1) business day, after learning of my/my child’s suspected or confirmed positive case of COVID-19 and/or the need to quarantine due to close contact with a person suspected or confirmed positive for COVID-19. I understand that I/my child may not return to in-person Youth Ministry activities until approved by Parish Administration. Approval will be based on confirmation by the local health department that the CDC's criteria to discontinue home isolation or quarantine has been met. Authorization and Faith Formation activities.Informed Consent I hereby authorize the Parish to enforce such other reasonable measures and directives as may be deemed necessary by the Xxxxxx of the Diocese of Arlington, its Office of Youth, Campus, and Young Adult Ministries, or the Parish leadership. I further understand that, in the event that it becomes necessary that events or programs should be canceled or administered via electronic media, I will not be entitled to a refund of any of my fees. By execution of this Agreement, I understand and agree to the foregoing terms and conditions. Student Signature (if 18 or older):

Liability Waiver. By signing this agreement, I acknowledge the contagious nature of COVID-19 and that my child(ren) and/or and/ or I may be exposed to or infected by COVID-19 by participating in in-person Parish and Faith Formation Youth Ministry activities, and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 at the above-named Parish or other venues may result from the actions, omissions, or negligence of myself, my child(ren) or others, including, but not limited to Diocesan or Parish administrators, employees, volunteers, and other program participants and their families. I further agree on behalf of myself and/or my child(renchild(xxx) named herein, and our respective heirs, successors, and assigns, to fully and forever to release, defend, indemnify, and hold harmless the Catholic Diocese of Arlington, the named Parishparish, their clergy, administrators, employees, agents, members and volunteers ("Indemnitees") from any and all claims, damages, demands, and causes of action, present or future, known or unknown, anticipated or unanticipated, in any way related to exposure to COVID-19 while participating in Parish and Faith Formation Youth Ministry activities, including but not limited to any claims of negligent exposure. This includes claims that arise from my own and others’ acts, actions, activities and/or omissions, excepting only those which that arise solely from the gross negligence, recklessness or intentional torts of Indemnitees, and those that are both (a) not asserted by our child or family or any member thereof, and (b) not alleged to arise from our acts or omissions. With respect to claims alleged to arise from our acts or omissions, our agreement to defend, indemnify and hold harmless the Indemnitees shall be effective only in the event that I, my child, or a member of our family is determined to be liable for such acts or omissions under applicable law, or by agreement. I will defend and indemnify Indemnitees with respect to any released claim, including but not limited to damages, costs and attorney’s fees. Responsibility for Health Screening By execution of this Statement, I affirm that my or my child(xxxchild(ren)’s presence at named Parish or Parish/Diocesan activity on any day constitutes dayconstitutes an affirmative representation on my part that I/we have performed the required all health screening below and affirm that steps required by the responses to all questions are NOParish for attendance or participation in Youth Ministry activities. SCREENING QUESTIONS “YES or NO, neither I nor my child(xxx) have any of the following:” • A fever of 100.4°F. (38°C.) or higher or a sense of having a fever during the past 72 hours • New or unexpected cough that cannot be attributed to another health condition • New shortness of breath or difficulty breathing that cannot be attributed to another health condition • New chills that cannot be attributed to another health condition • A new sore throat that cannot be attributed to another health condition • New muscle aches that cannot be attributed to another health condition or specific activity (such as physical exercise) • New loss of taste or smell • Nausea, vomiting or diarrhea • Currently living with a person who has exhibited symptoms of COVID-19 or is currently under quarantine due to close contact with a person suspected or confirmed to have COVID-19 “YES or NO, in the past 14 days, neither I nor my child(xxx) have done any of the following:” • Cared for or had other close contact with a person suspected or confirmed to have COVID-19 • Travelled internationally I understand that on any day when anyone in our household answers YES to any of my child(ren) does not pass the required health screening (which may include questions aboverelating to other members of the household as well as my child(ren)), I and/or my child(ren) are not permitted to participate in in-person Youth Ministry activities. Need to Inform and Quarantine I understand, in the event that I/my child is suspected or confirmed positive with COVID-19 or has come in close contact with a person suspected or confirmed positive with COVID-19, I/my child will need to follow the CDC’s guidance for isolation or quarantine as implemented by the Virginia Department of Health and local health departments. Information is available at xxx.xxx.xxx. I agree to inform the Parish administration as soon as possible, but no later than one (1) business day, after learning of my/my child’s suspected or confirmed positive case of COVID-19 and/or the need to quarantine due to close contact with a person suspected or confirmed positive for COVID-19. I understand that I/my child may not return to in-person Youth Ministry activities until approved by Parish Administration. Authorization and Faith Formation activities.Informed Consent I hereby authorize the Parish to enforce such other reasonable measures and directives as may be deemed necessary by the Xxxxxx of the Diocese of Arlington, its Office of Youth, Campus, and Young Adult Ministries, or the Parish leadership. I further understand that, in the event that it becomes necessary that events or programs should be canceled or administered via electronic media, I will not be entitled to a refund of any of my fees. By execution of this Agreement, I understand and agree to the foregoing terms and conditions. Student Signature (if 18 or older):

Liability Waiver. By signing this agreement, I acknowledge the contagious nature of COVID-19 and that my child(ren) and/or I may be exposed to or infected by COVID-19 by participating in in-person Parish and Faith Formation Youth Ministry activities, and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 at the above-named Parish may result from the actions, omissions, or negligence of myself, my child(ren) or others, including, but not limited to Diocesan or Parish administrators, employees, volunteers, and other program participants and their families. I further agree on behalf of myself and/or and my child(ren) named herein, and our respective heirs, successors, and assigns, to fully and forever release, defend, indemnify, and hold harmless the Catholic Diocese of Arlington, the named Parish, their clergy, administrators, employees, agents, members and volunteers ("Indemnitees") from any and all claims, damages, demands, and causes of action, present or future, known or unknown, anticipated or unanticipated, in any way related to exposure to COVID-19 while participating in Parish and Faith Formation Youth Ministry activities, including but not limited to any claims of negligent exposure. This includes claims that arise from my own and others’ acts, actions, activities and/or omissions, excepting only those which arise solely from the gross negligence, recklessness or intentional torts of Indemnitees. I will defend and indemnify Indemnitees with respect to any released claim, including but not limited to damages, costs and attorney’s fees. Responsibility for Health Screening By execution of this Statement, I affirm that my or my child(xxx)’s presence at named the Parish or participation in Youth Ministry activities on any day constitutes an affirmative representation on my part that I/we that I have performed the required health screening below and affirm that the responses to all questions are NO. SCREENING QUESTIONS “YES or NO, neither I nor my child(xxx) do not have any of the following:” • A fever of 100.4°F. F (38°C.) or higher or a sense of having a fever during the past 72 hours • New or unexpected cough that cannot be attributed to another health condition • New shortness of breath or difficulty breathing that cannot be attributed to another health condition • New chills that cannot be attributed to another health condition • A new sore throat that cannot be attributed to another health condition • New muscle aches that cannot be attributed to another health condition or specific activity (such as physical exercise) • New loss of taste or smell • Nausea, vomiting or diarrhea • Currently living with a person who has exhibited symptoms of COVID-19 or is currently under quarantine due to close contact with a person suspected or confirmed to have COVID-19 “YES or NO, in the past 14 days, neither I nor my child(xxx) have not done any of the following:” • Cared for or had other close contact with a person suspected or confirmed to have COVID-19 • Travelled internationally I understand that on any day when I or anyone in our my household answers YES to has any of the required health screening questions aboveabove symptoms or situations, I and/or my child(ren) are am not permitted to participate in Youth Ministry activities. Need to Inform and Quarantine I further understand, in the event that I am suspected or confirmed positive with COVID-19 or have come in close contact with a person suspected or confirmed positive with COVID-19, I will need to follow the CDC’s guidance for isolation or quarantine as appropriate. Information is available at xxx.xxx.xxx. I agree to inform the Parish administration as soon as possible, but no later than 1 business day, after learning of my suspected or confirmed positive case of COVID-19 and/or the need to quarantine due to close contact with a person suspected or confirmed positive for COVID-19. I understand that I may not return to in-person Youth Ministry activities until approved by Parish Administration. Approval will be based on confirmation that the CDC's criteria to discontinue home isolation or quarantine has been met. For details reference: For those suspected or confirmed positive: xxxxx://xxx.xxx.xxx/coronavirus/2019-ncov/if-you-are- sick/end-home-isolation.html For those quarantining due to close contact: xxxxx://xxx.xxx.xxx/coronavirus/2019-ncov/if-you-are- sick/quarantine.html Authorization and Faith Formation activities.Informed Consent I hereby authorize the Parish to enforce such other reasonable measures and directives as may be deemed necessary by the Xxxxxx of the Diocese of Arlington, its Office of Youth, Campus, and Young Adult Ministries, or the Pastor or Youth Ministry staff of the Parish. This Agreement has been prepared in the English language, and the English version thereof shall prevail and be binding in the event of any inconsistency even though a Spanish or other language translation may also be prepared. By execution of this Statement, I understand and agree to the foregoing terms and conditions. Signature:

Liability Waiver. By signing this agreement, I acknowledge the contagious nature of COVID-19 and that my child(ren) and/or I may be exposed to or infected by COVID-19 by participating in in-person Parish and Faith Formation ECEC activities, and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 at the above-named Parish ECEC may result from the actions, omissions, or negligence of myself, my child(ren) or others, including, but not limited to Diocesan or Parish ECEC administrators, employees, volunteers, and other students/program participants and their families. I further agree on behalf of myself and/or my child(ren) named herein, and our respective heirs, successors, and assigns, to fully and forever release, defend, indemnify, and hold harmless the Catholic Diocese of Arlington, St. John’s Lutheran Church and the named Parish, their clergyECEC, administrators, employees, agents, members and volunteers ("Indemnitees") from any and all claims, damages, demands, and causes of action, present or future, known or unknown, anticipated or unanticipated, in any way related to exposure to COVID-19 while participating in Parish and Faith Formation ECEC activities, including but not limited to any claims of negligent exposure. This includes claims that arise from my own and others’ acts, actions, activities and/or omissions, excepting only those which arise solely from the gross negligence, recklessness or intentional torts of Indemnitees. I will defend and indemnify Indemnitees with respect to any released claim, including but not limited to damages, costs and attorney’s fees. Responsibility for Health Screening By execution of this Statement, I affirm that my or my child(xxx)’s presence at named Parish ECEC on any day constitutes an affirmative representation on my part that I/we have performed the required health screening below and affirm that the responses to all questions are NO. SCREENING QUESTIONS “YES or NO, neither I nor my child(xxx) have any of the following:” • A fever of 100.4°F. (38°C.) or higher or a sense of having a fever during the past 72 hours • New or unexpected cough that cannot be attributed to another health condition • New shortness of breath or difficulty breathing that cannot be attributed to another health condition • New chills that cannot be attributed to another health condition • A new sore throat that cannot be attributed to another health condition • New muscle aches that cannot be attributed to another health condition or specific activity (such as physical exercise) • New loss of taste or smell • Nausea, vomiting or diarrhea • Currently living with a person who has exhibited symptoms of COVID-19 or is currently under quarantine due to close contact with a person suspected or confirmed to have COVID-19 “YES or NO, in the past 14 days, neither I nor my child(xxx) have done any of the following:” • Cared for or had other close contact with a person suspected or confirmed to have COVID-19 • Travelled internationally I understand that on any day when anyone in our household answers Answers YES to any of the required health screening questions above, I and/or and my child(ren) are not permitted to participate in in-person Parish and Faith Formation ECEC activities.

Liability Waiver. By signing this agreement, I acknowledge the contagious nature of COVID-19 and that my child(ren) and/or I may be exposed to or infected by COVID-19 by participating in in-person Parish and Faith Formation activities, and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 at the above-named Parish may result from the actions, omissions, or negligence of myself, my child(ren) or others, including, but not limited to Diocesan or Parish administrators, employees, volunteers, and other program participants and their families. I further agree on behalf of myself and/or my child(ren) named herein, and our respective heirs, successors, and assigns, to fully and forever release, defend, indemnify, and hold harmless the Catholic Diocese of Arlington, the named Parish, their clergy, administrators, employees, agents, members and volunteers ("Indemnitees") from any and all claims, damages, demands, and causes of action, present or future, known or unknown, anticipated or unanticipated, in any way related to exposure to COVID-19 while participating in Parish and Faith Formation activities, including but not limited to any claims of negligent exposure. This includes claims that arise from my own and others’ acts, actions, activities and/or omissions, excepting only those which arise solely from the gross negligence, recklessness or intentional torts of Indemnitees. I will defend and indemnify Indemnitees with respect to any released claim, including but not limited to damages, costs and attorney’s fees. Responsibility for Health Screening By execution of this Statement, I affirm that my or my child(xxx)’s presence at named Parish on any day constitutes an affirmative representation on my part that I/we have performed the required health screening below and affirm that the responses to all questions are NO. ONE FORM PER FAMILY SCREENING QUESTIONS “YES or NO, neither I nor my child(xxx) have any of the following:” • A fever of 100.4°F. (38°C.) or higher or a sense of having a fever during the past 72 hours • New or unexpected cough that cannot be attributed to another health condition • New shortness of breath or difficulty breathing that cannot be attributed to another health condition • New chills that cannot be attributed to another health condition • A new sore throat that cannot be attributed to another health condition • New muscle aches that cannot be attributed to another health condition or specific activity (such as physical exercise) • New loss of taste or smell • Nausea, vomiting or diarrhea • Currently living with a person who has exhibited symptoms of COVID-19 or is currently under quarantine due to close contact with a person suspected or confirmed to have COVID-19 “YES or NO, in the past 14 days, neither I nor my child(xxx) have done any of the following:” • Cared for or had other close contact with a person suspected or confirmed to have COVID-19 • Travelled internationally I understand that on any day when anyone in our household answers YES to any of the required health screening questions above, I and/or my child(ren) are not permitted to participate in in-person Parish and Faith Formation activities.

Liability Waiver. By signing this agreement, I acknowledge the contagious nature of COVID-19 and that my child(ren) and/or I may be exposed to or infected by COVID-19 a variety of hazards by participating in in-person Parish and Faith Formation ECEC activities, and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 or influenza at the above-named Parish ECEC may result from the actions, omissions, or negligence of myself, my child(ren) or others, including, but not limited to Diocesan or Parish ECEC administrators, employees, volunteers, and other students/program participants and their families. I further agree on behalf of myself and/or my child(renchild(xxx) named herein, and our respective heirs, successors, and assigns, to fully and forever release, defend, indemnify, and hold harmless the Catholic Diocese of Arlington, St. John’s Lutheran Church and the named Parish, their clergyECEC, administrators, employees, agents, members members, and volunteers ("Indemnitees") from any and all claims, damages, demands, and causes of action, present or future, known or unknown, anticipated or unanticipated, in any way related to exposure to COVID-19 events encountered while participating in Parish and Faith Formation ECEC activities, including but not limited to any claims of negligent exposure. This includes claims that arise from my own and others’ acts, actions, activities and/or omissions, excepting only those which arise solely from the gross negligence, recklessness or intentional torts of Indemnitees. I will defend and indemnify Indemnitees with respect to any released claim, including but not limited to damages, costs costs, and attorney’s fees. Responsibility for Health Screening for contagious viruses (i.e., influenza or COVID-19) By execution of this Statement, I affirm that my or my child(xxx)’s presence at named Parish ECEC on any day constitutes an affirmative representation on my part that I/we have performed the required health screening below and affirm that the responses to all questions are NO. SCREENING QUESTIONS “YES or NO, neither I nor my child(xxx) have any of the following:” • A fever Fever of 100.4°F. F (38°C.) or higher or a sense of having a fever during the past 72 hours • New or unexpected cough that cannot be attributed to another health condition • New shortness of breath or difficulty breathing that cannot be attributed to another health condition • New chills that cannot be attributed to another health condition • A new New sore throat that cannot be attributed to another health condition • New muscle aches that cannot be attributed to another health condition or specific activity (such as physical exercise) • New loss of taste or smell • Nausea, vomiting or diarrhea • Currently living with a person who has exhibited symptoms of influenza or COVID-19 or is currently under quarantine due to close contact with a person suspected or confirmed to have COVID-19 “YES or NO, in the past 14 days, neither I nor my child(xxx) have done any of the following:” • Cared for or had other close contact with a person suspected or confirmed to have COVID-19 • Travelled internationally I understand that on any day when anyone in our household answers YES to any of the required health screening questions above, I and/or and my child(ren) are not permitted to participate in in-person Parish and Faith Formation ECEC activities.

Liability Waiver. By signing this agreement, I acknowledge the contagious nature of COVID-19 and that my child(ren) and/or I may be exposed to or infected by COVID-19 by participating in in-person Parish and Faith Formation Youth Ministry activities, and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 at the above-named Parish may result from the actions, omissions, or negligence of myself, my child(ren) or others, including, but not limited to Diocesan or Parish administrators, employees, volunteers, and other program participants and their families. I further agree on behalf of myself and/or my child(ren) named herein, and our respective heirs, successors, and assigns, to fully and forever release, defend, indemnify, and hold harmless the Catholic Diocese of Arlington, the named Parish, their clergy, administrators, employees, agents, members and volunteers ("Indemnitees") from any and all claims, damages, demands, and causes of action, present or future, known or unknown, anticipated or unanticipated, in any way related to exposure to COVID-19 while participating in Parish and Faith Formation Youth Ministry activities, including but not limited to any claims of negligent exposure. This includes claims that arise from my own and others’ acts, actions, activities and/or omissions, excepting only those which arise solely from the gross negligence, recklessness or intentional torts of Indemnitees. I will defend and indemnify Indemnitees with respect to any released claim, including but not limited to damages, costs and attorney’s fees. Responsibility for Health Screening By execution of this Statement, I affirm that my or my child(xxxchild(ren)’s presence at named Parish on any day constitutes an affirmative representation on my part that I/we have performed the required health screening below and affirm that the responses to all questions are NO. SCREENING QUESTIONS “YES or NO, neither I nor my child(xxxchild(ren) have any of the following:” • A fever of 100.4°F. (38°C.) or higher or a sense of having a fever during the past 72 hours • New or unexpected cough that cannot be attributed to another health condition • New shortness of breath or difficulty breathing that cannot be attributed to another health condition • New chills that cannot be attributed to another health condition • A new sore throat that cannot be attributed to another health condition • New muscle aches that cannot be attributed to another health condition or specific activity (such as physical exercise) • New loss of taste or smell • Nausea, vomiting or diarrhea • Currently living with a person who has exhibited symptoms of COVID-19 or is currently under quarantine due to close contact with a person suspected or confirmed to have COVID-19 “YES or NO, in the past 14 days, neither I nor my child(xxxchild(ren) have done any of the following:” • Cared for or had other close contact with a person suspected or confirmed to have COVID-19 • Travelled internationally I understand that on any day when anyone in our household answers YES to any of the required health screening questions above, I and/or my child(ren) are not permitted to participate in in-person Youth Ministry activities. Need to Inform and Quarantine I further understand, in the event that I/my child is suspected or confirmed positive with COVID-19 or has come in close contact with a person suspected or confirmed positive with COVID-19, I/my child will need to follow the CDC’s guidance for isolation or quarantine as appropriate. Information is available at xxx.xxx.xxx. I agree to inform the Parish administration as soon as possible, but no later than 1 business day, after learning of my/my child’s suspected or confirmed positive case of COVID-19 and/or the need to quarantine due to close contact with a person suspected or confirmed positive for COVID-19. I understand that I/my child may not return to in-person Youth Ministry activities until approved by Parish Administration. Approval will be based on confirmation that the CDC's criteria to discontinue home isolation or quarantine has been met. For details reference: For those suspected or confirmed positive: xxxxx://xxx.xxx.xxx/coronavirus/2019-ncov/if-you-are-sick/end-home- isolation.html For those quarantining due to close contact: xxxxx://xxx.xxx.xxx/coronavirus/2019-ncov/if-you-are-sick/quarantine.html Authorization and Faith Formation activities.Informed Consent I hereby authorize the Parish to enforce such other reasonable measures and directives as may be deemed necessary by the Xxxxxx of the Diocese of Arlington, its Office of Youth, Campus, and Young Adult Ministries or the Parish leadership. I further understand that, in the event that it becomes necessary that events or programs should be cancelled or administered via electronic media, I will not be entitled to a refund of any of my fees. This Agreement has been prepared in the English language, and the English version thereof shall prevail and be binding in the event of any inconsistency even though a Spanish or other language translation may also be prepared. By execution of this Agreement, I understand and agree to the foregoing terms and conditions. Parent/Legal Guardian Signature:

Liability Waiver. I UNDERSTAND THAT THERE MAY BE RISKS ASSOCIATED WITH THE ABACOA COMMUNITY GARDEN. By signing this agreementbelow, I acknowledge hereby represent that I am familiar with and assume all risks in any way associated with my participation (or the contagious nature participation of COVID-19 and that my child(renminor child) and/or I may be exposed to or infected by COVID-19 by participating in in-person Parish and Faith Formation activities, and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 at the above-named Parish may result from the actionsreferenced club/activity which has been organized, omissionssponsored, or negligence of myselfendorsed in any manner by Abacoa Property Owners’ Assembly, my child(ren) or othersInc. (the “APOA”), includingand I hereby release the APOA and Renewal Church, but not limited to Diocesan or Parish administrators, their employees, volunteerslicensees, and other program participants and their families. I further agree on behalf of myself and/or my child(ren) named herein, and our respective heirs, successors, and assigns, to fully and forever release, defend, indemnify, and hold harmless the Catholic Diocese of Arlington, the named Parish, their clergy, administrators, employeesmembers, agents, members directors, officers, managers, and volunteers management company as well as any member of the garden ("Indemnitees"collectively the “RELEASEES”) from any and all claimsclaims for damages for personal injury, damagesdeath, demandsor property damage of any kind which may hereafter accrue to me (or my minor child, and causes of actionif I have signed below for a minor) or any person, present as a result of, or future, known or unknown, anticipated or unanticipated, in any way related to, my (or said minor’s child’s) participation in, or presence at, the above-referenced activity at any time. This release from liability also releases the RELEASEES from any liability or claims related to exposure the use of photographs or videos, for publicity purposes related to COVID-19 while participating in Parish and Faith Formation the Abacoa clubs/activities, including but not limited to of the undersigned participant (and any claims of negligent exposureminor child the undersigned is signing this document on behalf of). This includes claims that arise assumption of risks and release from my own and others’ acts, actions, activities and/or omissions, excepting only those which arise solely from the gross negligence, recklessness or intentional torts of Indemnitees. I will defend and indemnify Indemnitees with respect to any released claim, including but not limited to damages, costs and attorney’s fees. Responsibility for Health Screening By execution of this Statement, I affirm that my or my child(xxx)’s presence at named Parish on any day constitutes an affirmative representation liability shall be binding on my part that I/we have performed (and said minor’s child’s) heirs and assigns, and shall operate to bar all claims against the required health screening below and affirm that the responses to all questions are NO. SCREENING QUESTIONS “YES RELEASEES regardless of whether liability may arise out of negligence or NO, neither I nor my child(xxx) have any carelessness of the followingRELEASEES. PERPETUAL EFFECT OF THIS DOCUMENT: I AGREE THAT THIS ASSUMPTION OF RISK, WAIVER AND RELEASE OF LIABILITY AGREEMENT EXTENDS INTO THE FUTURE AND COVERS ANY AND ALL VISITS FOR WHICH THIS AGREEMENT APPLIES, AS WELL AS ANY RETURN OR REPEAT VISITS BY EITHER MYSELF OR MY MINOR CHILD. PRINT Participant Name SIGN Participant Signature PRINT Guardian Name SIGN Guardian Signature I have read and agree to abide by the Liability Waiver. DATE: ABACOA COMMUNITY GARDEN 2022-2023 INDIVIDUAL PLOT AGREEMENT If you are interested in an Individual Plot, contact Xxxxxx Xxxxxxx xxxxxxxxxxx@xxxxx.xxx for information and availability. Name: Address: Preferred Phone: E-mail: You must be a current Abacoa Community Garden Member IMPORTANT: Returning IP members should include payment with application. NEW member IP bed requests - do NOT include payment. Plots will be assigned July/August. Payment shall be due upon plot assignment. Individual Plot Fees *Full Sized Plot: $90 (*For Full Size Renewal ONLY. Not available to new members or for current 1/2 plot upgrade) ½ Sized Plot: $45 Table Top Bed: $35 Mail signed agreement and check made payable to Abacoa POA Abacoa Community Garden c/o Abacoa POA, Inc. 0000 Xxxxxxxxxx Xxxx. Suite 102 Jupiter, FL 33458 I have read and agree to abide by the guidelines on IP Membership Agreement Page 2. PRINT NAME SIGN NAME DATE INDIVIDUAL PLOT GUIDELINES:” • A fever of 100.4°F. (38°C.) or higher or a sense of having a fever during the past 72 hours • New or unexpected cough that cannot be attributed to another health condition • New shortness of breath or difficulty breathing that cannot be attributed to another health condition • New chills that cannot be attributed to another health condition • A new sore throat that cannot be attributed to another health condition • New muscle aches that cannot be attributed to another health condition or specific activity (such as physical exercise) • New loss of taste or smell • Nausea, vomiting or diarrhea • Currently living with a person who has exhibited symptoms of COVID-19 or is currently under quarantine due to close contact with a person suspected or confirmed to have COVID-19 “YES or NO, in the past 14 days, neither I nor my child(xxx) have done any of the following:” • Cared for or had other close contact with a person suspected or confirmed to have COVID-19 • Travelled internationally I understand that on any day when anyone in our household answers YES to any of the required health screening questions above, I and/or my child(ren) are not permitted to participate in in-person Parish and Faith Formation activities.