Sorrento VIA Activities Member Representations, Liability Release and Indemnification Form, 2022
I, the parent/guardian,of the following minor(s):
hereby make the following representations on my behalf and on behalf of any minor child in my household (“My Household”):
a. My Household understands the hazards posed by COVID-19 and is familiar with the Centers for Disease Control and Prevention (“CDC”) guidelines regarding COVID-19, as well as the latest guidelines from the State of Maine found on maine.gov/covid19 website, including, currently, Physical Distancing, and appropriate mask wearing for unvaccinated individuals. If wearing a mask is more comfortable for me, I will do so. We acknowledge and understand that the circumstances regarding COVID-19 are changing from day to day and that, accordingly, the CDC and Maine guidelines are regularly modified and updated, and we accept full responsibility for remaining familiar with the most recent updates.
b. My Household is not currently under a quarantine advisement or order issued by a healthcare provider or a state, local, or federal government agency; we will comply with all state and federal recommendations designed to limit the risk of viral transmission while in a VIA sponsored activity; if our child(ren) is/are vaccinated they will not need to wear a mask, but may if they are more comfortable doing so: if our child(ren) is/are not vaccinated they will have a negative COVID-19 test result within 72 hours of their first activity and agree to wear a mask indoors, when social distancing can’t be maintained or when requested by a lead counselor. If an unvaccinated child is potentially exposed to Covid-19 while they in Sorrento, they will take another test and have a negative result before resuming activities.
c. My Household is not currently exhibiting any of the following symptoms (the “Symptoms”), associated with COVID-19: fever, coughing, shortness of breath, chills, muscle pain, sore throat, or loss of taste or smell.
d. If My Household has ever exhibited Symptoms, it has been at least 7-days since we have ceased exhibiting Symptoms without the use of Symptom-suppressing medication, and at least 21-days since our Symptoms first presented themselves.
e. My Household has not tested positive for COVID-19, OR, if we have tested positive for COVID-19, we have had two consecutive negative COVID-19 tests that were conducted more than 24 hours apart, and we have not exhibited Symptoms as set forth in (d) above;
f. If, after signing this document, My Household tests positive for COVID-19, or if we exhibit Symptoms, we will not attend any VIA activities, until the conditions set forth in (d) or (e) above, whichever is applicable, have been satisfied.
g. My Household understands that the VIA is relying on the representations contained herein, in order to permit My Household to participate in activities.
h. My Household understands that if it has been untruthful about any of the representations contained in this document, its access to VIA activities may be suspended until my Household can demonstrate that it is complying with its representations.
Liability Release and Indemnification
I consent to minor’s participation in the activities and acknowledge that the minor and I fully understand minor’s participation may involve risk of serious injury or death, including losses or harm from: minor’s own actions, inactions, or negligence; the actions, inactions, or negligence of others; the condition of the facilities, equipment, or areas where the activities are being conducted; and/or the rules of play of this type of event or activity. I understand that if I have any risk concerns, I should discuss the risk associated with minor’s participation with the sailing instructors before I sign this document and before any activities begin.
In consideration of allowing minor to participate in the activities, I hereby release and hold harmless The Sorrento Yacht Club, Sorrento Village Improvement Association, their members of the respective boards of trustees, officers, employees, volunteers, other participants, and agents collectively, the (“Released Parties”), of and from, and do discharge and waive, any and all claims, demands, losses, damages, and liabilities that minor or I may have or sustain, whether individually or on minor’s behalf, with respect to any and all damage and/or injury, of any type, arising out of minor participating in the activities. I also agree that if any portion of this argument is held to be invalid the balance shall continue in full force and effect.
The undersigned further agree to hold harmless, indemnify, and save the Released Parties from any and all claims, demands, losses, damages, and liabilities for indemnities, contribution, or otherwise with respect to any damage and/or injury of any type arising from minor’s participation in the activities. The undersigned also agree that this Agreement in all parties extends to all acts by the Released Parties, with the exception of gross negligence or intentional misconduct and is intended to be as broad and inclusive as is permitted by the laws of the State of Maine in which the activities are conducted and that if any portion thereof is held invalid, it is agreed that the balance shall continue in full legal force and effect.
I certify that minor is in good health and has no physical condition that would prevent participation in activities. Furthermore, I agree to use my/minor’s personal medical insurance as a primary medical coverage payment if accident or injury occurs. I consent to emergency medical treatment in the event such care is required.