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CUSTOMER / CLIENTCOVID-19 CONSENT AND WAIVER

By signing this “Customer/Client COVID-19 Consent and Waiver” (“Consent”), I acknowledge and agree to the following statements and terms regarding MASE Training (“Business” if applicable).

COVID-19 Information.  I understand that the outbreak of the 2019 novel coronavirus or “COVID-19” has been declared a worldwide pandemic by the World Health Organization. I am aware of the current information and news relating to COVID-19. I understand that COVID-19 is extremely contagious, is believed to spread by person-to-person contact, and has caused illness, respiratory illness, disabilities, hospitalization and death. As a result, local, state and federal governmental authorities, health agencies and related organizations have issued orders and guidelines on taking safety measures, including (as some examples) social distancing, stay-at-home, use of personal protective equipment (PPE), and sanitizing and personal hygiene practices.

Company Policies.  I understand the Business is taking extensive safety precautions to try to reduce the risk of spreading COVID-19 and to safeguard its customers/clients and its “Staff” (which means employees, independent contractors, managers and officers) by establishing rules and policies and procedures (together referred to as “Rules”). The Business has a statement of the Rules (as amended from time to time) on its website and on a sign(s) or handouts displayed, posted or laid out in its shop/store/gym/office, and refers to these Rules as the “COVID-19 Company Policy for Customers/Clients,” which is incorporated by reference into and made a part of this Consent.

Acknowledgment, Assumption of Risk, Release of Liability. I acknowledge and agree to the following:

1. I am voluntarily entering the “Business Premises” (which means outside or inside the Business shop/store/gym/office) and/or interacting with the Staff on the Business Premises (referred to as “interactions (or interacting) with Staff”), by myself or with “My Group Member(s)” which means my child(ren) and any other person accompanying me, to purchase or receive products or services from the Business or for any other reason. My Group Member(s) may also be a Business customer/client.

2. I read and understand the COVID-19 Company Policy for Customers/Clients.

3. I promise to follow and cause My Group Member(s) to follow, all customer/client Rules required by the Business, as presented to me verbally or in writing, or in its COVID-19 Company Policy for Customers/Clients.

4. Despite the Business’ extensive safety precautions and its Rules for customers/clients and Staff to follow, given the nature of COVID-19, I understand, on behalf of myself and My Group Member(s), the inherent risk of becoming infected with or exposed to COVID-19 and any related symptoms when I or My Group Member(s) enter(s) the Business Premises or interacts with Staff.

5. Accordingly, I assume, on behalf of myself and My Group Member(s), any and all risks of becoming infected with or exposed to COVID-19 and any related symptoms by entering the Business Premises or interacting with Staff.

6. I understand that “Third Parties,” which means suppliers or vendors providing the Business with business-related products or services or any other third parties, may by chance enter the Business Premises or interact with Staff while I or My Group Member(s) is/are on the Business Premises or interacting with Staff. In such cases, the Business will require all such Third Parties to follow the Rules.

7. I understand the risk of becoming exposed to or infected by COVID-19 and any related symptoms, from being present on the Business Premises or interacting with Staff, may result from the actions, omissions, or negligence of myself, My Group Member(s), Staff or Third Parties present on the Business Premises or interacting with Staff.

8. I understand that, even if I or My Group Member(s) previously recovered from COVID-19, it is currently not conclusive whether re-infection with COVID-19 is possible or not; therefore, I must still agree to this Consent, and I must comply, and cause My Group Member(s) to comply, with the terms of this Consent.

9. I understand that if I or My Group Member(s) have/has been tested negative for COVID-19, the tests in some cases may fail to detect the disease; therefore, I must still agree to this Consent, and I must comply, and cause My Group Member(s) to comply, with the terms of this Consent.

10. I knowingly and voluntarily proceed at my own free will and take full responsibility for any injury (including but not limited to illness, death, disability, damage, loss, claim, liability of any kind) to myself and My Group Member(s).

Release of Claims. On behalf of myself and My Group Member(s), and each of our heirs, next of kin, spouses, guardians, agents, representatives, executors, administrators and successors (“Releasing Parties”), and to the maximum extent permitted by law, I irrevocably and unconditionally release and forever discharge the “Released Parties” (which means the Business, Staff, Third Parties and the Business shareholders, members, successors, assigns and authorized representatives) from any and all present and future (including unknown and unsuspected but later discovered) claims, actions or causes of action, proceedings, complaints, demands, allegations, suits, damages, liabilities, losses, costs, expenses and injuries of any kind whatsoever (including without limitation, attorney’s fees and costs and related fees), whether brought before a court of law, arbitration panel, mediator or governmental agency or related body and whether based on the actions, omissions or negligence of the Released Parties (“Claims”), directly or indirectly caused by, arising out of, resulting from, or relating to COVID-19 and any related symptoms or illness and/or by reason of my or My Group Member’s(s’) presence on the Business Premises or interactions with Staff at any time during the entirety of the COVID-19 pandemic on any legal or equitable theory whatsoever, and whether any infection of or exposure to COVID-19 and any related symptoms occurred before, during or after any of my or My Group Member’s(s’) visits to the Business Premises or interactions with Staff (collectively, “Released Claims”). I knowingly and voluntarily waive, on behalf of myself and My Group Member(s), any law or regulation that may supersede the release terms in this Consent.

Indemnification. On behalf of myself and My Group Member(s), I agree to defend, indemnify, and hold harmless the Released Parties from and against any and all Released Claims caused by, arising out of, resulting from, or relating to, my or My Group Member’s(s’) presence on the Business premises or interactions with Staff.

Severability. If any provision is held to be illegal, invalid, or unenforceable, such provision will be deleted and the remainder of this Consent will remain in full force and effect, and a valid provision similar in terms to the illegal, invalid or unenforceable provision will be substituted.

Thermal/Temperature Detection Measures. As part of the Business efforts to help reduce the risk of spreading the COVID-19 and safeguarding its customers/clients and Staff, the Business has implemented mitigation measures related to assessing the health and medical condition of all persons entering the Business Premises. Such mitigation measures include, without limitation, the Business and Staff using a non-invasive temperature detection equipment to detect human body temperature of all such persons and inquiring about and observing all such persons’ health and medical conditions, including those listed below under “Appointment/Session Day Confirmations.” The Business will collect and maintain all such information under conditions of confidentiality.

I understand, agree, and voluntarily consent, on behalf of myself and My Group Member(s), to all such mitigation measures and the Business and Staff collecting and maintaining my information related to such mitigation measures, and also waive all Claims related to such mitigation measures.

Appointment/Session Day Confirmations. I acknowledge the following on behalf of myself or My Group Member(s) (in such case, “I” means My Group Member who is the Customer/Client):

  • I have not been coughing, and I do not have a sore throat.
  • I do not have shortness of breath, and I do not have trouble breathing.
  • I do not have red eye(s), or any symptoms of conjunctivitis.
  • I have not lost my sense of smell or taste.
  • I am not experiencing fatigue, fever, muscle aches/pain, chills, shaking, or persistent headaches.
  • I am not experiencing any confusion or having trouble staying awake, and I do not have bluish lips or face.
  • I do not have persistent pain or pressure in my chest.
  • I have NOT been in close contact with a person who is ill or known to have COVID-19 or related symptoms.


Date: April 16, 2024

First Participant's Name

First Name*

Last Name*
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 Information

I had COVID-19 or related symptoms on approximately (date)
First Participant's Signature*
Second Participant's Name

First Name*

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

I had COVID-19 or related symptoms on approximately (date)
Third Participant's Name

First Name*

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

I had COVID-19 or related symptoms on approximately (date)
Fourth Participant's Name

First Name*

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

I had COVID-19 or related symptoms on approximately (date)
Fifth Participant's Name

First Name*

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

I had COVID-19 or related symptoms on approximately (date)
Sixth Participant's Name

First Name*

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

I had COVID-19 or related symptoms on approximately (date)
Seventh Participant's Name

First Name*

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

I had COVID-19 or related symptoms on approximately (date)
Eighth Participant's Name

First Name*

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

I had COVID-19 or related symptoms on approximately (date)
Ninth Participant's Name

First Name*

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

I had COVID-19 or related symptoms on approximately (date)
Tenth Participant's Name

First Name*

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

I had COVID-19 or related symptoms on approximately (date)
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*
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 Information

I had COVID-19 or related symptoms on approximately (date)
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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