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Most Worshipful Prince Hall Grand Lodge of South Carolina
Columbia, South Carolina
803.254.7210
2324 Gervais Street, Columbia, SC
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Covid-19 Liability Waiver
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Covid-19 Liability Waiver
MOST WORSHIPFUL PRINCE HALL GRAND LODGE of SOUTH CAROLINA
FREE & ACCEPTED MASONS
COVID-19 Liability Waiver and Statement of Understanding
Name:
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Last
Telephone #:
Address:
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1. I voluntarily seek admission to
2. I understand that this event will include "in-person" activities. I further acknowledge that I may be increasing my risk of exposure to the Coronavirus/COVID-19 as a result.
3. I understand the contagious nature of the Coronavirus/COVID-19 and that the Center for Disease Control (CDC) and many other public health authorities recommend practicing the following precautionary measures, including, but not limited to, social distancing of at least six (6) feet apart, frequent hand-washing and hand-sanitizing, and wearing a face covering or mask over one's mouth and nose.
4. I understand that for all "in-person" activities every reasonable step will be taken to provide a safe environment in conformance with Applicable CDC and local public health authority recommendations. I acknowledge that I too must comply with all precautionary measures as set forth above to reduce the risk of contagion during this event/function.
5. I further understand that, notwithstanding all safety precautions being taken, the risk of contracting COVID-19 during an "in-person" activity cannot be eliminated completely. Therefore,
I, on behalf of myself, my heirs, and any personal representatives, hereby release and agree to hold harmless
and the Most Worshipful Prince Hall Grand Lodge of South Carolina, together with all members, agents and employees, from any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property, including but not limited to, bodily injury, illness, death, or medical treatment,
that may be caused by any act, or failure to act of
or the Most Worshipful Prince Hall Grand Lodge of South Carolina, or that may otherwise arise in any way as a result of, and in connection with, the Coronavirus/COVID-19.
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