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MRC Hockey Team Waiver

 

 

 

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID -19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state and local governments and federal and state health agencies recommend social distancing and have in many locations, prohibited the congregation of groups of people. 

Midcoast Recreation Center (MRC) has put in place preventative measures to reduce the spread of COVID-19; however, MRC cannot guarantee that you or your team players will not become infected with COVID-19. Further, attending events at MRC could increase your risk and your players risks of contracting COVID-19. 

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntary assume the risk of my organization. I understand we (the team) may be exposed to or infected by COVID-19 by attending an event at MRC and that such exposure or infection may result in personal injury, illness, permanent disability and death. I understand the risk of becoming exposed to or infected by COVID-19 at the MRC may result from the action, omissions, or neglicence of myself and others, including, but not limited to MRC employees, volunteers, and program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept responsibility for any injury to my program or myself ( including, but not limited to, personal injury, disability and death.) Illness damage loss, claim, liability, or exxpense, of any kind, that I or my players may experience or incur in connection with my players at MRC. ( " Claims") On my behalf, and on behalf of my players, I hereby release, covenant not to sue, discharge, and hold harmless MRC ,its employees, agests and representatives, of and from Claims, including all liabilities, claims actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and gree that this release includes any Claims based on the actions, omissions or neglicence of MRC, its employees, agests and representatives, whether a COVID- 19 infection occurs before, during, or after participation in any MRC event or program. 

As the coach, I have read, understood, the safety protocols at MRC. I will follow, share, and enforce these protocols with my team, coaches, parents and any additional persons associated with my club or program. I will also bring to the attention any situation, action, or circumstance that may be considered dangerous or infectious to the proper authority at MRC. 

I Agree
I have read and understood the above.

I Agree
I have read and understood guidelines for MRC that are listed on our website titled " Covid-19 Guidelines"

 

Team Name

Coach Name (print)

Coach Name (sign)

October 27, 2020

First Coaches Name

First Name*

Middle Name

Last Name*

Phone*
First Coaches Date of Birth*
First Coaches Signature*
Second Coaches Name

First Name*

Middle Name

Last Name*
Second Coaches Date of Birth*
Third Coaches Name

First Name*

Middle Name

Last Name*
Third Coaches Date of Birth*
Fourth Coaches Name

First Name*

Middle Name

Last Name*
Fourth Coaches Date of Birth*
Fifth Coaches Name

First Name*

Middle Name

Last Name*
Fifth Coaches Date of Birth*
Sixth Coaches Name

First Name*

Middle Name

Last Name*
Sixth Coaches Date of Birth*
Seventh Coaches Name

First Name*

Middle Name

Last Name*
Seventh Coaches Date of Birth*
Eighth Coaches Name

First Name*

Middle Name

Last Name*
Eighth Coaches Date of Birth*
Ninth Coaches Name

First Name*

Middle Name

Last Name*
Ninth Coaches Date of Birth*
Tenth Coaches Name

First Name*

Middle Name

Last Name*
Tenth Coaches Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
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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*

Phone*
Parent or Guardian's Date of Birth*
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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