Loading...

COMMUNICABLE DISEASE EXPOSURE AND INFECTION ASSUMPTION OF RISK, HOLD HARMLESS, RELEASE, WAIVER OF LIABILITY AND INDEMNITY AGREEMENT

 

Today's Date: April 19, 2024

As lawful consideration for my being granted access to this facility or any NHRA Member Track (“Facility”), and being permitted to participate in its activities, including but not limited to being allowed to drive, compete, crew, officiate, spectate, observe, work, volunteer, participate in any way or otherwise be granted entrance to Facility for any reason (“Activities”), and by signing below, I acknowledge that I have read, understand, and agree to the following, on my own behalf, on behalf of any minor accompanying me, and on behalf of my personal representatives, heirs and next of kin, agents and principals:

  1. The novel coronavirus, COVID-19, also known as “severe acute respiratory syndrome coronavirus 2 (“SARS-CoV-2”) has been declared a worldwide pandemic by governments and public health agencies.  SARS-CoV-2, COVID-19 and/or any mutation or variation thereof (hereinafter “COVID-19”) is extremely contagiousCOVID-19 and other communicable, contagious and/or infectious diseases, and (collectively, “Disease”) can be spread by exposure to people or otherwise.
  2. At any location, including Facility, the risk exists that Disease can be spread to those present at the location. Additionally, there is a risk that someone infected with Disease could spread it to others who were not present at Facility.
  3. The health impacts of Disease including without limitation COVID-19 are not fully known although at present certain people are considered to be at higher risk from COVID-19 based on age, underlying health conditions and other factors known and unknown. 
  4. The unavoidable risk exists that I will become exposed to and/or infected with Disease, and could suffer resulting and/or related death, disability, illness, sickness, infection, disease, syndrome and/or other undesirable health condition, whether now known or unknown, from Disease, . 
  5. I am aware that my participation in the Activities and my presence at Facility will cause me to be near and/or in contact with people and/or things that could raise the risk to me and others of exposure to Disease.
  6. No one, including Releasees as defined below, can eliminate the risk that I will become exposed to or infected by or otherwise experience Disease.  I know these risks cannot be eliminated no matter the degree of care exercised by anyone affiliated with Facility or Activities  No amount of protective measures or devices can guarantee freedom from Disease.  By being at Facility, including, without limitation, participating in Activities, I know I could suffer personal injuries, or become ill, temporarily disabled, permanently disabled and/or die (collectively “Afflicted”) from Disease.  I voluntarily assume these risks and accept sole responsibility that I may be exposed to and/or Afflicted by Disease by entering Facility or participating in Activities.
  7. Knowing the foregoing risks, including the fact that there are unknown risks, I voluntarily choose to enter and be at Facility and to assume these risks of my own free will.  I will not seek to hold any Releasee as defined below responsible if I am Afflicted by Disease
  8. If I choose not to assume these risks, I will neither enter Facility nor participate in Activities, and by staying at Facility I affirm my continuing acceptance of all such risks.
  9. I understand that being Afflicted by Disease may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Releasees as defined below.
  10. I hereby RELEASE, WAIVE, DISCHARGE and COVENANT NOT TO SUE the promoters, participants, racing associations, sanctioning organizations or any affiliated entities thereof, Facility owners, Facility operators, track operators, track owners, officials, vehicle owners, builders and designers, drivers, crews, rescue personnel, any persons in any restricted area, promoters, sponsors, equipment and parts manufacturers and suppliers, advertisers, owners and lessees of premises used to conduct Activities, premises and event inspectors, those who clean and maintain Facility, concessionaires and vendors, volunteers, surveyors, underwriters/brokers, consultants and others who give recommendations, directions, or instructions or engage in risk evaluation or loss control activities regarding the premises or Activities, and for each of them, their directors, officers, agents, employees, representatives, owners, members, affiliates, successors and assigns, collectively referred to as “RELEASEES”, FROM ALL LIABILITY TO ME, my personal representatives, assigns, heirs, and next of kin, agents and principals FOR ANY AND ALL LOSS OR DAMAGE, AND ANY CLAIM OR DEMANDS THEREFOR, WHETHER CAUSED BY THE NEGLIGENCE OF ANY RELEASEE(S) OR OTHERWISE INCLUDING EXPOSURE TO DISEASE, THAT MAY RESULT IN ILLNESS, INJURY, DISABILITY AND/OR DEATH.  I understand and agree that this release includes claims based on the actions, omissions, or negligence of any RELEASEE whether Disease exposure occurs before, during, or after entry to Facility and/or participation in Activities at Facility.
  11. I hereby agree to INDEMNIFY and SAVE AND HOLD HARMLESS the Releasees and each of them from any loss, liability, damage, or cost (including their attorneys’ fees and costs) that they may incur arising out of or related in any manner to my attendance at or participation in Activities.   
  12. HEALTH & SAFETY DECLARATION. I attest and certify that I do not now have and have not tested positive for or suffered from any symptoms of COVID-19 infection including without limitation cough; shortness of breath or difficulty breathing; fever; chills; repeated shaking with chills; generalized muscle pain; headache; sore throat; new loss of sense of taste or smell; fatigue or other flu-like symptoms (collectively the “Symptoms”), or been exposed to any person exhibiting such Symptoms or, traveled outside the United States or to a location known to harbor such disease, in the past thirty (30) days.  I am not under any quarantine orders.
  13. PERSONAL PROTECTIVE EQUIPMENT AND DISTANCING.  I will provide and use my own personal protective equipment and practice social distancing (current CDC guidance is at least 6 feet from others whenever possible) and follow all other hygiene and infection control methods, as prescribed by applicable authorities such as the United States Centers for Disease Control, state and local health officials, or otherwise in effect at this Facility, to help protect myself and others from Disease
  14. LEAVING IF ILL.  If while at Facility I feel or experience any Symptoms I agree that I will immediately leave Facility to seek medical attention (or seek emergency medical attention at Facility) and that I promptly will notify Facility officials of same.
  15. NOT RESTRICTED BY GOVERNMENT ORDERS OR PERSONAL PHYSICIAN.  I represent and warrant that my attendance at Facility and participation in Activities is not restricted by the advice of my personal physician or any governmental or public health order or rule of any federal, state, county or other applicable authority, including any order or rule due to my age, condition, government or public health orders of isolation due to illness or quarantine due to my exposure to others who are, were or may have been sick, or for any other reason.  If I believe this to not be the case, I will either not enter, or will promptly depart, Facility
  16. KNOWING AND VOLUNTARY.  I acknowledge that I am voluntarily participating in Activities and visiting the Facility with an express understanding regarding the coronavirus pandemic and the other dangers described above, and I hereby agree to accept and assume any and all risks associated therewith.  I have made the judgment that the benefits of being at Facility outweigh the risks that I am assuming. 
  17. SEVERABILITY AND ENFORCEMENT.  This Agreement is intended to be as broad and inclusive as is permitted by the laws of the Province or State in which Activities are conducted and if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.  I intend for this Agreement to apply any time I am present at any Facility during dates noted above.

BY SIGNING BELOW, I ACKNOWLEDGE THAT I HAVE READ AND FULLY UNDERSTOOD ALL OF THE TERMS OF THIS AGREEMENT, UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP LEGAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, ORAL REPRESENTATIONS OR GUARANTEE BEING MADE TO ME, AND INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF LIABILITY TO THE GREATEST EXTENT PERMITTED BY LAW, INCLUDING THE RIGHT, DIRECTLY OR INDIRECTLY, TO SUE THE RELEASED PARTIES.

 

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!