COVID-19 Liability Waiver
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Name
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Phone
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Email
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I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing.
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I Agree
I further acknowledge that Impact Lives Church cannot guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Impact Lives Church staff, and congregants, or families.
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I agree
I will not attend a service at Impact Lives Church if I am experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.
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I Agree
As it pertains to matters related to COVID-19, I hereby release and agree to hold Impact Lives Church harmless from, and waive on behalf of myself, my child(ren), and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself, child(ren) and/or property that may be caused by any act, or failure to act of the church, or that may otherwise arise in any way in connection with any services received from Impact Lives Church. I understand that this release discharges Impact Lives Church from any liability or claim that I, my child(ren), or any personal representatives may have against the church with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from Impact Lives Church. This liability waiver and release extends to the church together with all owners, partners, and employees.
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I Agree
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Date Signed
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