In-Person Gathering Health Screening Form
COVID-19 has been declared a worldwide pandemic and is extremely contagious. As a result, in order to resume activities, social distancing and other essential safety measures have been established. Reasonable preventative measures have been put into place along with standards of behavior in an effort to reduce the spread of COVID-19. Even with the implementation of safety protocols, the Jewish Federation cannot guarantee that you will not become infected with COVID-19 and attendance at and/or participation in the gathering could increase your risk of contracting COVID-19. If you are considered high-risk by the Centers for Disease Control and Prevention to have a severe response to COVID-19, the Federation strongly encourages you to (if available) attend and/or participate in the gathering remotely.
By attending, you acknowledge the contagious nature of COVID-19 and that I may be exposed to or infected by COVID-19 by attending and/or by participating in the gathering, and that such exposure or infection may result in personal injury, illness, permanent disability, and death. By attending, you understand that the risk of becoming exposed to or infected by COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to Jewish Federation employees, volunteers, and participants and their families.
You further agree to absolutely release and hold harmless the gathering, the Jewish Federation, and its members, directors, officers, employees, attorneys, agents, and representatives arising from or in connection with any alleged negligent acts or omissions of those entities or individuals, from any and all claims and causes of action in any way related to attendance at the gathering, including but not limited to any claims of negligent exposure.
I understand that I will be required to answer a series of health screening questions prior to my participation and that if my answer to any of the health screen questions is “Yes,” I am not permitted to attend.
I acknowledge that in return I am receiving the benefit of being able to attend and/or participate in the gathering.
This Statement is intended to be as broad and inclusive as is permitted by law. If any part of this Statement is held to be invalid or legally unenforceable for any reason, the remainder of this provision shall not be affected thereby and shall remain valid and fully enforceable.