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OTE Miami, LLC. dba
The Edge Rock Gym

Release of Liability and Assumption of Risk

For Minor Participants: If you are submitting this form for your minor child but you - the legal guardian - will not be present for the first visit but rather have your child accompanied by another authorized adult, they will be required to bring a copy or photo of the legal guardian's driver license upon their first visit to The Edge Rock Gym.

This waiver must be completed for each adult and minor who will be staying within the facility and is valid for 12 months.

THIS IS A LEGALLY BINDING AGREEMENT. Read it carefully before signing, and consult with an attorney if you are uncertain about its terms. Alterations are not permitted. This Agreement must be read and signed by all participants 14 years of age and older. If the participant is a minor (under 18), it must be signed also by the child's natural guardian (defined by pertinent Florida law as the child's mother or father, by birth or adoption, or, if the parents are divorced, the parent to whom custody is awarded). The natural guardian signs for himself or herself and on behalf of the child. Minors presenting this form bearing the signature of a natural guardian may be required to prove the authenticity of the signature. A minor who signs this agreement does so to reflect his or her understanding of the activities and their risks.

SPECIAL NOTICE TO THE MINOR CHILD'S NATURAL GUARDIAN READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT EVEN IF OTE Miami, LLC., ITS OWNERS, SUCCESSORS, AFFILIATES, EMPLOYEES AND AGENTS (IDENTIFIED AS "RELEASED PARTIES", BELOW) USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED. BY SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD'S RIGHT AND YOUR RIGHT TO RECOVER FROM A RELEASED PARTY IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND RELEASED PARTIES HAVE THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM.


In consideration of being allowed to participate, participant and, if participant is a minor, natural guardian, acknowledge and agree as follows:


1. Activities and Risks

Climbing on artificial climbing walls, and related activities (including, but not limited to, bouldering, challenge type activities and fitness or exercise classes) exposes participants to numerous risks which might result in physical and emotional injury, death or property loss or damage. These risks include, among others, the following: falling, to the floor or pads; falling or swinging into the climbing wall and other structures and objects; being struck by falling climbers, hardware, tools, broken or dropped holds and other objects; entanglement in ropes; abrasions and/other injuries from contact with climbing walls, ropes, holds, loose holds, dropped holds, broken holds, pads, or the floor. Climbing and belaying equipment and structures may malfunction, be defective, or fail; and absorbing materials, including pads, below the wall may not prevent all injuries from falls. Participants may participate out of control or beyond their limits or otherwise act in a negligent or intentional manner which contributes to the injury or death of themselves or another participant. Staff, visitors, belayers and other persons present may act negligently or engage in other wrongful conduct. OTE Miami, LLC. may fail to warn participants or the natural guardians of certain inherent risks. These risks are inherent in a participant's enrollment and climbing and related activities and they cannot be eliminated without altering the nature of the experience. Other risks may be encountered. If I am the natural guardian of a minor participant, I have explained the risks and possible outcomes to the child. I, and the child, understand them and we both choose for the child to participate nevertheless. My, or the child's, participation is voluntary.

Related to Risk Infection of Coronavirus/COVID-19

I know that indoor and outdoor climbing and fitness gym usage is a close contact sport that heightens the risk of exposure to coronavirus. I know that I could be exposed to coronavirus at OTE Miami, LLC.  and could become ill after such exposure. I agree that OTE Miami, LLC. has taken reasonable precautions to prevent my exposure to coronavirus and that no amount of care or caution by OTE Miami, LLC can eliminate the risk that I am exposed to coronavirus or develop illness.

2. Assumption of Risks:

I, participant or, if the participant is a minor, natural guardian, for myself and on behalf of the child, to the maximum extent allowed by law, understand, acknowledge and assume any and all risks of OTE Miami, LLC. activities and the use of its facilities and equipment, inherent or not, and whether or not described in this document.

3.  Release and Indemnity (Adult participant):

I, an adult participant, hereby release and covenant not to sue OTE Miami, LLC., its owners, successors, affiliates,  employees and agents (hereinafter each a "Released Party", or collectively "Released Parties"), with respect to liability for any personal injury, including death, property loss or damage, and all other claims, demands or causes of action which  accrue to me, which are in any way related to my enrollment or participation in an activity of OTE Miami, LLC. or the use of its facilities or equipment. In addition, I agree to protect, defend, hold harmless and indemnify (including the payment of reasonable attorneys fees, costs and insurance deductibles) Released Parties and each of them with respect to any claim of loss suffered or caused by me, by whomever it may be brought, which relates in any way to my enrollment in an activity of OTE Miami, LLC. or the use of its facilities or equipment. These agreements of release and indemnity include claims of negligent (including, to the extent allowed by law, grossly negligent) acts or omissions of a Released Party, but not intentionally wrongful conduct.

Waiver of Claims and Liability Related to Infection of Coronavirus/COVID-19

I agree that there is no way to determine if any illness I may get is the fault of or cause by OTE Miami, LLC, and I waive any claim I may make that OTE Miami, LLC caused any illness I may develop. I voluntarily agree of my own free will to be at OTE Miami, LLC and participate in activities at OTE Miami, LLC. I assume any risk of infection and covenant not to sue OTE Miami, LLC and if I do sue, it is a breach of this agreement which is legally enforceable.

4. Release and Indemnity (Natural guardian for himself or herself and on behalf of a minor participant):

As the natural guardian of the minor participant I, for myself and on behalf of my minor child, hereby release and covenant not to sue OTE Miami, LLC., its owners, successors, affiliates, employees and agents (hereinafter each a "Released Party", or collectively "Released Parties"), with respect to liability for any personal injury, including death, property loss or damage, and any and all other claims, demands or causes of action which accrue to me or to my child which are in any way related to the child's enrollment or participation in an activity of OTE Miami, LLC. or the use of its facilities or equipment. The claims which I hereby release for myself include claims of negligent (including, to the extent allowed by law, grossly negligent) acts or omissions of a Released Party, but not intentionally wrongful conduct. The claims which I release on behalf of my child are those which accrue to the child resulting from an inherent risk of the child's enrollment or participation in an activity of OTE Miami, LLC. or the use of its facilities or equipment. (IMPORTANT: for purposes of this Release by the natural guardian on behalf of the minor child "inherent risk" is defined by pertinent Florida law as those dangers or conditions, known or unknown, which are characteristic of, intrinsic to, or an integral part of the activity and which are not eliminated even if the activity provider acts with due care in a reasonable manner. The term includes, among other acts or omissions, the failure of the activity provider to warn the natural guardian or child of an inherent risk, and the negligent or intentional acts of the child or another participant which may contribute to the injury or death of the minor participant. "Participant" for purposes of this Release, DOES NOT include OTE Miami, LLC. its owners, successors, affiliates, employees and agents.) In addition, I agree to protect, defend, hold harmless and indemnify (including the payment of reasonable attorneys fees, costs and insurance deductibles) Released Parties and each of them, with respect to any claim of loss suffered or caused by the child, by whomever it may be brought, in any way related to my minor childs enrollment in an activity of OTE Miami, LLC. or the use of its facilities or equipment. This agreement of indemnity include claims of negligent (including, to the extent allowed by law, grossly negligent) acts or omissions of a Released Party, but not intentionally wrongful conduct.

Waiver of Claims and Liability Related to Infection of Coronavirus/COVID-19

I agree that there is no way to determine if any illness I or my minor child or children may get is the fault of or cause by OTE Miami, LLC, and I waive any claim I may make that OTE Miami, LLC caused any illness I or my minor child or children may develop. I voluntarily agree of my own free will for myself and my minor child or children to be at OTE Miami, LLC and participate in activities at OTE Miami, LLC. I assume any risk of infection and covenant not to sue OTE Miami, LLC and if I do sue, it is a breach of this agreement which is legally enforceable.

5. Other:

a. I, an adult participant or natural guardian, agree that if any part of this Agreement is held by a court of law to be unenforceable, the remainder shall survive. It is my intent to comply fully with Florida law, including with respect to a natural guardian's authority to release certain claims on behalf of his or her child or ward. The venue of any legal action arising out  of, concerning or involving this document, or a claim of any sort against a Released Party will be Miami-Dade County, Florida. I agree also that the laws of the State of Florida (not including the laws which might apply of another jurisdiction) will be applied to an interpretation of this Agreement and any dispute which arises between me, or the child, and a Released Party.

b.l agree further that this agreement will remain in full force and effect, and apply to subsequent visits to OTE Miami, LLC. by me, or the minor child, until revoked in writing, with notice to the other party. Future participation and use of OTE Miami, LLC. is evidence of my or the child's, continuing agreement with the terms of this document.

c.l understand that photographs and video recordings which include me or the child may be taken at OTE Miami, LLC.'s facilities. I agree that OTE Miami, LLC. may use my or the child's likeness in any and all of its publications and advertisements without payment or any other consideration.

d.OTE Miami, LLC. wants to provide a fun environment for all participants and spectators. I, and the child,understand and agree that OTE Miami, LLC. reserves the right to deny or revoke access to anyone for any act deemed inappropriate.

e.l, or the child and I, have read, understand and agree to obey the posted Safety Rules which are printed and available at OTE Miami, LLC. and its website.

I represent that I have complete and absolute authority to bind, contract for and legally act on behalf of myself and the minor participant, and understand and agree that RELEASED PARTIES rely to their detriment upon this representation and would not allow the minor child to participate without this representation. I have had sufficient opportunity to read and understand this document and intend for it to be binding on me, the minor child who is a participant, and members of my, and the child's, respective families, estates and personal representatives.Natural Guardian(s) must sign below for the minor child to participate and agree that they and the minor child are subject to all the terms of this document, as set forth above.

FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION)

This is to certify that I, as parent/guardian with legal responsibility for ,do consent and agree to his/her release as provided above of all the Releasees, and for myself, my child and our heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child's involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.

Date: September 20, 2020

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Statement Regarding Coronavirus/COVID-19
"I (or my minor child) do NOT have the coronavirus." *
I agree with the statement above.
"I (or my minor child) have NOT been exposed to the coronavirus in the last 14 days." *
I agree to the statement above.
"I (or my minor child) have NOT traveled outside of the United States in the past 14 days." *
I agree to the statement above.
"I (or my minor child) do NOT presently have a cough." *
I agree to the statement above.
"I am NOT (or my minor child is NOT) presently frequently sneezing." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) experience shortness of breath." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) have a fever above or equal to 100° F (37.7° C)." *
I agree to the statement above.

"On my own behalf (and/or on behalf of my minor child) - I/we will be mindful of my/our proximity to others and observe social distancing recommendations of remaining at least 6 ft away from other individuals inside or outside of the facility, to be mindful of personal contact, and to wear appropriate face covering at all times within the facility. 

"I/we may remove my face covering briefly to hydrate, but understand that if I need to catch my breath for longer or to have a snack that I should inform the staff that I/we would like to step outside momentarily, and I will NOT let people into the facility behind me so that staff mayy conduct temperature checks first."

I agree to the understand and agree to the statement above.
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Statement Regarding Coronavirus/COVID-19
"I (or my minor child) do NOT have the coronavirus." *
I agree with the statement above.
"I (or my minor child) have NOT been exposed to the coronavirus in the last 14 days." *
I agree to the statement above.
"I (or my minor child) have NOT traveled outside of the United States in the past 14 days." *
I agree to the statement above.
"I (or my minor child) do NOT presently have a cough." *
I agree to the statement above.
"I am NOT (or my minor child is NOT) presently frequently sneezing." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) experience shortness of breath." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) have a fever above or equal to 100° F (37.7° C)." *
I agree to the statement above.

"On my own behalf (and/or on behalf of my minor child) - I/we will be mindful of my/our proximity to others and observe social distancing recommendations of remaining at least 6 ft away from other individuals inside or outside of the facility, to be mindful of personal contact, and to wear appropriate face covering at all times within the facility. 

"I/we may remove my face covering briefly to hydrate, but understand that if I need to catch my breath for longer or to have a snack that I should inform the staff that I/we would like to step outside momentarily, and I will NOT let people into the facility behind me so that staff mayy conduct temperature checks first."

I agree to the understand and agree to the statement above.
Second Participant's Signature*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Statement Regarding Coronavirus/COVID-19
"I (or my minor child) do NOT have the coronavirus." *
I agree with the statement above.
"I (or my minor child) have NOT been exposed to the coronavirus in the last 14 days." *
I agree to the statement above.
"I (or my minor child) have NOT traveled outside of the United States in the past 14 days." *
I agree to the statement above.
"I (or my minor child) do NOT presently have a cough." *
I agree to the statement above.
"I am NOT (or my minor child is NOT) presently frequently sneezing." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) experience shortness of breath." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) have a fever above or equal to 100° F (37.7° C)." *
I agree to the statement above.

"On my own behalf (and/or on behalf of my minor child) - I/we will be mindful of my/our proximity to others and observe social distancing recommendations of remaining at least 6 ft away from other individuals inside or outside of the facility, to be mindful of personal contact, and to wear appropriate face covering at all times within the facility. 

"I/we may remove my face covering briefly to hydrate, but understand that if I need to catch my breath for longer or to have a snack that I should inform the staff that I/we would like to step outside momentarily, and I will NOT let people into the facility behind me so that staff mayy conduct temperature checks first."

I agree to the understand and agree to the statement above.
Third Participant's Signature*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Statement Regarding Coronavirus/COVID-19
"I (or my minor child) do NOT have the coronavirus." *
I agree with the statement above.
"I (or my minor child) have NOT been exposed to the coronavirus in the last 14 days." *
I agree to the statement above.
"I (or my minor child) have NOT traveled outside of the United States in the past 14 days." *
I agree to the statement above.
"I (or my minor child) do NOT presently have a cough." *
I agree to the statement above.
"I am NOT (or my minor child is NOT) presently frequently sneezing." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) experience shortness of breath." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) have a fever above or equal to 100° F (37.7° C)." *
I agree to the statement above.

"On my own behalf (and/or on behalf of my minor child) - I/we will be mindful of my/our proximity to others and observe social distancing recommendations of remaining at least 6 ft away from other individuals inside or outside of the facility, to be mindful of personal contact, and to wear appropriate face covering at all times within the facility. 

"I/we may remove my face covering briefly to hydrate, but understand that if I need to catch my breath for longer or to have a snack that I should inform the staff that I/we would like to step outside momentarily, and I will NOT let people into the facility behind me so that staff mayy conduct temperature checks first."

I agree to the understand and agree to the statement above.
Fourth Participant's Signature*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Statement Regarding Coronavirus/COVID-19
"I (or my minor child) do NOT have the coronavirus." *
I agree with the statement above.
"I (or my minor child) have NOT been exposed to the coronavirus in the last 14 days." *
I agree to the statement above.
"I (or my minor child) have NOT traveled outside of the United States in the past 14 days." *
I agree to the statement above.
"I (or my minor child) do NOT presently have a cough." *
I agree to the statement above.
"I am NOT (or my minor child is NOT) presently frequently sneezing." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) experience shortness of breath." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) have a fever above or equal to 100° F (37.7° C)." *
I agree to the statement above.

"On my own behalf (and/or on behalf of my minor child) - I/we will be mindful of my/our proximity to others and observe social distancing recommendations of remaining at least 6 ft away from other individuals inside or outside of the facility, to be mindful of personal contact, and to wear appropriate face covering at all times within the facility. 

"I/we may remove my face covering briefly to hydrate, but understand that if I need to catch my breath for longer or to have a snack that I should inform the staff that I/we would like to step outside momentarily, and I will NOT let people into the facility behind me so that staff mayy conduct temperature checks first."

I agree to the understand and agree to the statement above.
Fifth Participant's Signature*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Statement Regarding Coronavirus/COVID-19
"I (or my minor child) do NOT have the coronavirus." *
I agree with the statement above.
"I (or my minor child) have NOT been exposed to the coronavirus in the last 14 days." *
I agree to the statement above.
"I (or my minor child) have NOT traveled outside of the United States in the past 14 days." *
I agree to the statement above.
"I (or my minor child) do NOT presently have a cough." *
I agree to the statement above.
"I am NOT (or my minor child is NOT) presently frequently sneezing." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) experience shortness of breath." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) have a fever above or equal to 100° F (37.7° C)." *
I agree to the statement above.

"On my own behalf (and/or on behalf of my minor child) - I/we will be mindful of my/our proximity to others and observe social distancing recommendations of remaining at least 6 ft away from other individuals inside or outside of the facility, to be mindful of personal contact, and to wear appropriate face covering at all times within the facility. 

"I/we may remove my face covering briefly to hydrate, but understand that if I need to catch my breath for longer or to have a snack that I should inform the staff that I/we would like to step outside momentarily, and I will NOT let people into the facility behind me so that staff mayy conduct temperature checks first."

I agree to the understand and agree to the statement above.
Sixth Participant's Signature*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Statement Regarding Coronavirus/COVID-19
"I (or my minor child) do NOT have the coronavirus." *
I agree with the statement above.
"I (or my minor child) have NOT been exposed to the coronavirus in the last 14 days." *
I agree to the statement above.
"I (or my minor child) have NOT traveled outside of the United States in the past 14 days." *
I agree to the statement above.
"I (or my minor child) do NOT presently have a cough." *
I agree to the statement above.
"I am NOT (or my minor child is NOT) presently frequently sneezing." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) experience shortness of breath." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) have a fever above or equal to 100° F (37.7° C)." *
I agree to the statement above.

"On my own behalf (and/or on behalf of my minor child) - I/we will be mindful of my/our proximity to others and observe social distancing recommendations of remaining at least 6 ft away from other individuals inside or outside of the facility, to be mindful of personal contact, and to wear appropriate face covering at all times within the facility. 

"I/we may remove my face covering briefly to hydrate, but understand that if I need to catch my breath for longer or to have a snack that I should inform the staff that I/we would like to step outside momentarily, and I will NOT let people into the facility behind me so that staff mayy conduct temperature checks first."

I agree to the understand and agree to the statement above.
Seventh Participant's Signature*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Statement Regarding Coronavirus/COVID-19
"I (or my minor child) do NOT have the coronavirus." *
I agree with the statement above.
"I (or my minor child) have NOT been exposed to the coronavirus in the last 14 days." *
I agree to the statement above.
"I (or my minor child) have NOT traveled outside of the United States in the past 14 days." *
I agree to the statement above.
"I (or my minor child) do NOT presently have a cough." *
I agree to the statement above.
"I am NOT (or my minor child is NOT) presently frequently sneezing." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) experience shortness of breath." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) have a fever above or equal to 100° F (37.7° C)." *
I agree to the statement above.

"On my own behalf (and/or on behalf of my minor child) - I/we will be mindful of my/our proximity to others and observe social distancing recommendations of remaining at least 6 ft away from other individuals inside or outside of the facility, to be mindful of personal contact, and to wear appropriate face covering at all times within the facility. 

"I/we may remove my face covering briefly to hydrate, but understand that if I need to catch my breath for longer or to have a snack that I should inform the staff that I/we would like to step outside momentarily, and I will NOT let people into the facility behind me so that staff mayy conduct temperature checks first."

I agree to the understand and agree to the statement above.
Eighth Participant's Signature*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Statement Regarding Coronavirus/COVID-19
"I (or my minor child) do NOT have the coronavirus." *
I agree with the statement above.
"I (or my minor child) have NOT been exposed to the coronavirus in the last 14 days." *
I agree to the statement above.
"I (or my minor child) have NOT traveled outside of the United States in the past 14 days." *
I agree to the statement above.
"I (or my minor child) do NOT presently have a cough." *
I agree to the statement above.
"I am NOT (or my minor child is NOT) presently frequently sneezing." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) experience shortness of breath." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) have a fever above or equal to 100° F (37.7° C)." *
I agree to the statement above.

"On my own behalf (and/or on behalf of my minor child) - I/we will be mindful of my/our proximity to others and observe social distancing recommendations of remaining at least 6 ft away from other individuals inside or outside of the facility, to be mindful of personal contact, and to wear appropriate face covering at all times within the facility. 

"I/we may remove my face covering briefly to hydrate, but understand that if I need to catch my breath for longer or to have a snack that I should inform the staff that I/we would like to step outside momentarily, and I will NOT let people into the facility behind me so that staff mayy conduct temperature checks first."

I agree to the understand and agree to the statement above.
Ninth Participant's Signature*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Statement Regarding Coronavirus/COVID-19
"I (or my minor child) do NOT have the coronavirus." *
I agree with the statement above.
"I (or my minor child) have NOT been exposed to the coronavirus in the last 14 days." *
I agree to the statement above.
"I (or my minor child) have NOT traveled outside of the United States in the past 14 days." *
I agree to the statement above.
"I (or my minor child) do NOT presently have a cough." *
I agree to the statement above.
"I am NOT (or my minor child is NOT) presently frequently sneezing." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) experience shortness of breath." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) have a fever above or equal to 100° F (37.7° C)." *
I agree to the statement above.

"On my own behalf (and/or on behalf of my minor child) - I/we will be mindful of my/our proximity to others and observe social distancing recommendations of remaining at least 6 ft away from other individuals inside or outside of the facility, to be mindful of personal contact, and to wear appropriate face covering at all times within the facility. 

"I/we may remove my face covering briefly to hydrate, but understand that if I need to catch my breath for longer or to have a snack that I should inform the staff that I/we would like to step outside momentarily, and I will NOT let people into the facility behind me so that staff mayy conduct temperature checks first."

I agree to the understand and agree to the statement above.
Tenth Participant's Signature*
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*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
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.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Statement Regarding Coronavirus/COVID-19
"I (or my minor child) do NOT have the coronavirus." *
I agree with the statement above.
"I (or my minor child) have NOT been exposed to the coronavirus in the last 14 days." *
I agree to the statement above.
"I (or my minor child) have NOT traveled outside of the United States in the past 14 days." *
I agree to the statement above.
"I (or my minor child) do NOT presently have a cough." *
I agree to the statement above.
"I am NOT (or my minor child is NOT) presently frequently sneezing." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) experience shortness of breath." *
I agree to the statement above.
"I do NOT (or my minor child does NOT) have a fever above or equal to 100° F (37.7° C)." *
I agree to the statement above.

"On my own behalf (and/or on behalf of my minor child) - I/we will be mindful of my/our proximity to others and observe social distancing recommendations of remaining at least 6 ft away from other individuals inside or outside of the facility, to be mindful of personal contact, and to wear appropriate face covering at all times within the facility. 

"I/we may remove my face covering briefly to hydrate, but understand that if I need to catch my breath for longer or to have a snack that I should inform the staff that I/we would like to step outside momentarily, and I will NOT let people into the facility behind me so that staff mayy conduct temperature checks first."

I agree to the understand and agree to the statement above.
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.


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