Event Attendee Waiver and Release of Liability Form
The 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.
Attendees of events held or sponsored by the North Carolina Black Alliance (NCBA) must practice social distancing and face coverings must be worn at all times to reduce the risks of exposure to COVID-19. NCBA has established preventative measures to reduce the spread of COVID-19. However, NCBA cannot guarantee that its participants, volunteers, partners, or others in attendance will not become infected with COVID-19.
Please review the agreement below. Individuals who fall within any of the categories below should not participate in any in-person NCBA events or activities. By attending an in-person NCBA event, I acknowledge, undersign and agree to the following:
- In the past 14 days, I confirm that I have not experienced any COVID-19 related symptoms as outlined by the Center for Disease Control and Prevention (CDC), such as fever, dry cough or shortness of breath.
- In the past 14 days, I nor any member of my household has been diagnosed with COVID-19 and has not been exposed to or in close contact with anyone who has tested positive for COVID-19.
- In the past 30 days, I nor any member of my household have traveled internationally.
- In the past 14 days, I nor any member of my household have visited a community in the United States that has been reported as a highly impacted COVID-19 area.
- I acknowledge that I must follow all safety precautions that have been implemented by NCBA, including practicing social distancing and wearing the proper PPE.
- I understand that I may be asked to leave the event by NCBA staff should I exhibit any behavior that is in violation of the organization’s guidelines and safety measures.