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COVID Waiver Template

[administrator notice: content below memberonly level=”Group Membership for Businesses of 2-5 individuals, Student, Individual or Solo-Preneur”]

Update this template as necessary based on the laws in your municipality.




The novel 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.


                                                        has put in place preventative measures to reduce the spread of COVID-19; however,

                                                            cannot guarantee that you will not become infected with COVID-19. Further, attending in-person classes/lessons/practices could increase your risk of contracting COVID-19. These Safe Space prevention measures were clearly explained to me.


By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by attending in-person classes/lessons/practices and that such exposure or infection may result in personal injury, illness, permanent disability, and death.


I understand that the risk of becoming exposed to or infected by COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to,                                                                         employees, volunteers, and program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my attendance or participation in                                                                                  (“Claims”).


On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless _____________, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of                                                                                                      , its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any in-person classes/lessons/practices or activity.

Legal Full Name (Printed):                                                             





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