We're excited to gather our ASK families together to enjoy an afternoon of fall fun! We'll bounce on inflatables, decorate pumpkins, enjoy fall treats, play games, and visit with other ASK families in the beautiful outdoors!

Event Details:
Saturday, October 23
1 - 4 pm
Bon Secours Training Center
2401 W Leigh Street
Richmond, VA 23220

Please only invite/register immediate family members who live in your household to this ASK event. Thank you!

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* 1. Your ASK kid's first & last name

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* 2. Your first & last name

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* 3. Your email address

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* 4. Your cell phone number so we can text you last-minute details and reminders

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* 5. Attendee 1's first & last name

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* 6. Attendee 2's first & last name

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* 7. Attendee 3's first & last name

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* 8. Attendee 4's first & last name

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* 9. Attendee 5's first & last name

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* 10. Attendee 6's first & last name

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* 11. COVID-19 Acknowledgement & Release:

This Acknowledgement and Assumption of Risk (this “Release”) contains important information relating to ASK Childhood Cancer Foundation (“ASK”) programs and functions during the COVID-19 pandemic, including your agreement to assume all risks of any kind associated with participation in ASK programs and functions for yourself and your minor child(ren). Please read it carefully.

By signing below, you acknowledge and agree that:

1. The SARS-CoV-2 virus, which causes COVID-19 (collectively, “COVID-19”), is highly contagious and can result in a range of symptoms which include, but are not limited to, fever, shortness of breath, sore throat, cough, fatigue, loss of taste or smell, diarrhea, and nausea or vomiting. Symptoms of COVID-19 can be mild or severe and related risks include severe illness and death. For additional information on the spread and effect of COVID-19, please visit:
https://www.cdc.gov/coronavirus/2019-ncov/index.html.

2. ASK and its personnel will use their good faith efforts to comply with state and federal (including CDC) guidelines to safeguard against the spread of COVID-19 virus, but can make no assurances regarding the safety of ASK programs and events.

3. You and your child(ren) and family members will comply fully with all ASK protocols and requirements (“COVID Protocols”) intended to safeguard against the spread of COVID-19, and will not be permitted to participate if you fail to do so. ASK COVID Protocols include, without limitation, the following:

a. You will consult with your physician and follow his or her advice regarding participation in ASK programs or events. You agree to ask your physician specifically about your child(ren)’s immune-compromised status, risk of contracting COVID-19, and risk of suffering from serious illness.

b. Before coming to any in-person program or interaction of any kind, you will conduct a health screening of all family members who will be present and confirm that no person has any of the following symptoms of COVID-19 (“Symptoms”):
• Temperature above 100.4 degrees
• Dry cough or coughing
• Shortness of breath/difficulty breathing
• Sore throat
• Congestion or runny nose
• Nausea, vomiting or diarrhea
• Fatigue
• Loss of taste or smell

c. By participating in any ASK in-person program or event, you certify that, to your knowledge, neither your child(ren) nor any other family participant has been exposed to any person who has tested positive for COVID-19 or has any Symptoms in the past fourteen (14) days, nor do your child(ren) or other family participants live with any person who is sick with, or quarantined due to, COVID-19.

d. While participating in any in-person ASK program or event, you will comply fully with all ASK protocols governing face masks, social distancing, hand-washing, sanitation, and other COVID-19 related precautions.

4. You acknowledge and agree that no list of restrictions, guidelines, or practices will remove 100% of the risk of exposure to COVID-19, as the virus can be transmitted by persons who are asymptomatic and before people show signs of infection.

5. By participating or allowing your child(ren) or other family members to participate in any in-person ASK program or event, you agree that you assume all risk related to COVID-19 for yourselves and on behalf of your child(ren) and other family members. You acknowledge that your agreement to assume such risks is a material inducement to ASK’s decision to permit you to participate in ASK programs and events. If you do not wish to assume the risk of COVID-19 illness for yourself and your child(ren) and family members, you should not sign this Release.

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