Consent Form - Covid-19 Risk
I, hereby certify, represent and warrant as follows:
I understand the novel corona virus causes the disease known as COVID-19 and am aware of its symptoms and risks.
I understand the novel corona virus has a long incubation period during which carriers of the virus may not show symptoms and still be contagious.
I further acknowledge that Bayside Sports has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19.
I also acknowledge that Bayside Sports 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, Bayside Sports staff, and other Bayside Sports clients and their families.
I voluntarily seek services provided by Bayside Sports during the state directed lockdown in the wake of the current Covid 19 risk in Mumbai and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19.
If I am an asymptomatic carrier or an undiagnosed patient with COVID 19, I may endanger the Bayside Sports staff and other Bayside Sports clients and their families.
I acknowledge that I must take appropriate precautions and follow the social distancing and other protocols prescribed by the Government of India as well as the state government.
I am aware that I may get the COVID -19 infection from players and Bayside support staff on the ground, but I will not hold Bayside Sports management and /or all its clients, employees and staff accountable - criminally/financially or in any other way liable, if I am infected.
Within the twenty one (21) days immediately preceding the date of visiting Bayside Sports training/ground facilities, now and any future visits, I HAVE NOT:
Tested positive or presumptively positive with the Corona virus or been identified as a potential carrier of the COVID-19 virus or similar communicable illness.
Am not waiting for the results of a laboratory test for the novel corona virus.
Been in any location positively designated as hazardous and/or potentially infected with the Corona virus by a recognized health or regulatory authority.
Been in direct contact with or the immediate vicinity of any person I knew and/or now know to be carrying the Corona virus or has been identified as a potential carrier of the Corona virus.
Have not been identified or been asked to self-isolate by any other governmental health agency.
Have not shown any symptoms associated with corona virus, listed on the form
I AGREE to notify Bayside Sports by emailing (email@example.com) of any change in status, including diagnosis with Corona virus and/or quarantine. I verify the information I have provided on this form is truthful and accurate.
I hereby release and agree to hold Bayside Sports harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, that may otherwise arise in any way in connection with any services received from Bayside Sports. I understand that this release discharges Bayside Sports from any liability or claim that I, my heirs, or any personal representatives may have against the organizers of Bayside Sports 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 Bayside Sports. This liability waiver and release extends to the entire company together with all owners, partners, directors and employees.
I AFFIRM that all the above statements apply equally to the following minors under the age of 18 (either with me or with my consent)