Broward Homeschool Parent Support Group
 

COVID-19 Release Form

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1. *

Please write your first and last name.

COVID-19 Release Form

Additional Liability Agreement concerning COVID-19.  The following is currently being added to the Broward County Homeschool Parent Support Group (PSG) Release of Liability.  You have already read and signed the general Release of Liability.  Please read and sign for these additional statements.  These statements are not separate from the Release of Liability.  Rather, they have been added where appropriate to the PSG Release of Liability.

I and members of my family:

  • Acknowledge that my family’s participation in PSG and my family’s utilization of the Abundant Living Ministries Church (ALM) AND/OR Pines Baptist Church (PBC) facility could expose my family to a possible risk of personal injury, and exposure to COVID-19, and that such injury, COVID-19 exposure, etc., could lead to illness, permanent injury or death, and that I assume all risks and accept sole responsibility that is inherent in such participation and/or utilization.
  • Release and agree to indemnify and hold harmless PSG, ALM and PBC, which includes any PSG member, board member or volunteer, and any ALM and PBC officers, elder, staff member, employee, volunteer, and agent from any and all liability, loss, damage, personal injury, COVID-19 exposure, and/or claims arising from my family’s participation and/or utilization, including claims that are known or unknown, foreseen or unforeseen, future or contingent.
2. *

By checking the box below, I affirm that I have read, acknowledge, agree to abide by, and have submitted the COVID-19 Release Form.

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Yes, I agree
3. 

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