Player Waiver Form - FALL 2020

To be completed by each participant.

I fully understand that the Winston-Salem Sports and Social Club (WSSSC), officials, or any sponsor will not be responsible for accidents, injuries or property damage. I hereby release and hold harmless the "WSSSC", its agents and employees from liability for any and all claims, damages and/ or injuries. I do not expect remuneration, either directly or indirectly for playing, but play for the pleasure and physical, mental, social and moral benefit I may derive therefrom. Further, the Player shall inspect, to his/her satisfaction, the playing surface and facilities prior to participating in each game, and his/her participation in each game shall be a waiver of any claim that the playing surface or facilities are defective or dangerous for purposes of the game. All players must be 21 yrs of age or older.

Addtional COVID-19 Statement

I understand that I am assuming the risk and waive of liability for myself relating to Coronavirus/COVID-19. 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 gathering limits.

I understand that Winston-Salem Sports & Social Club (WSSSC) has put in place preventative measures based on recommendations from the Centers of Disease Control and the North Carolina Department of Health and Human Services to reduce the spread of COVID-19. However, I understand all preventative measures cannot guarantee that I will not become infected with COVID-19. I know that attending kickball games could increase my risk of contracting COVID-19.

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 kickball games operated by WSSSC 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 at WSSSC kickball games may result from the actions, omissions, or negligence of myself and others, including, but not limited to, WSSSC employees, other participants and their families.

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my 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 myself attendance at kickball games operated by WSSSC. On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless the WSSSC, 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 the WSSSC, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any games or events offered by WSSSC.

I have read ALL the ABOVE statement along with the game rules and regulations.

Typing your full name in the box BELOW is equivalent to a handwritten signature