COVID-19 Release Form

Coronavirus/ Covid-19 Release Waiver

COVID-19 has been declared a worldwide pandemic by the World Health Organization. Life Journey Community Church (“LJCC”) has established preventative measures and policies to reduce the risk of spread of COVID-19. LJCC cannot, however, guarantee that you, your child(ren), will not become exposed to and infected with COVID- 19. This Waiver and Release of Liability Relating to Coronavirus/COVID-19 (“Waiver and Release”) is effective for the entire 2021 calendar year and encompasses any and all OneEighty events and activities (“LJCC activities”). OneEighty is a ministry of LJCC.

I acknowledge that I have read each paragraph of the Waiver and Release.

I acknowledge that I had the opportunity, before signing the Waiver and Release, to ask questions about, discuss, and negotiate any of the terms set forth in the Waiver and Release.

I acknowledge and understand the contagious nature of COVID-19, and I voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by participating in LJCC activities, and that such exposure or infection may result in personal injury, illness, disability, or death.

I acknowledge and understand that I am agreeing to the terms set forth in the Waiver and Release, as consideration for my child(ren) being permitted to participate in LJCC activities.

I acknowledge and understand that the risk of becoming exposed to or infected by COVID-19 while participating in LJCC activities may result from the actions, omissions, or negligence of myself and others, including, but not limited to, LJCC employees, volunteers, and all of LJCC’s program participants and their families. I acknowledge and understand that it is impossible to eliminate the risk that my child(ren), and my family, become exposed to and infected by COVID-19 when participating in LJCC activities.

I, for myself, my child(ren), my heirs, personal representatives or assigns, voluntarily agree to assume the risk that my child(ren), and my family, may be exposed to, and become infected by, COVID-19, when participating in LJCC activities, and I agree to accept responsibility for any injury that my child(ren), or my family, may experience in connection with LJCC activities, including, but not limited to, personal injury, disability, illness, and death. I voluntarily agree to release LJCC and its officers, directors, agents, volunteers, and insurers (the “Released Parties”) from and against any and all liability, claims, demands, actions, damages, or causes of action of any kind arising from or related to my child(ren) or I being exposed to or infected by COVID-19 when participating in LJCC activities.

  • By signing this Electronic Signature Field, I agree that my electronic signature is the legally binding equivalent to my handwritten signature. I acknowledge Life Journey Community Church will use my electronic signature to act on my behalf.