TURKEY MOUNTAIN LIABILITY AND WAIVER FORM

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* 1. YOUR NAME

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* 2. ADDRESS

Address

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 3. LIST ANY CHILDREN YOU WILL BE SUPERVISING TONIGHT

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* 4. PLEASE CAREFULLY READ THE WAIVER & RELEASE OF LIABILITY

By my digital/virtual signature below, I confirm my understanding of the following concerning my voluntary participation in today’s event. I choose to participate in this activity at my own risk and I will abide by any and all instructions provided to participants to help assure my own safety and that of my participating family members, if applicable. I agree to assume all risks associated with my participation in this activity and I indemnify and hold harmless the River Parks Authority, the City of Tulsa, Tulsa County, WSA Soccer, Tulsa Field Sports Alliance, and their respective officers, directors, employees, contractors, volunteers, and/or agents for any claims for personal injury or property damage resulting from or in any way connected with my participation in today’s activity.

I have read and understand and accept the terms and conditions outlined above on my behalf and on behalf of my entire party and any children I am supervising during the event.

I UNDERSTAND and AGREE

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* 5. BY TYPING YOUR NAME BELOW YOU OFFER YOUR DIGITAL SIGNATURE AS AN UNDERSTANDING OF THESE TERMS FOR YOUR PARTICIPATION (and your children's participation under your supervision).

COVID19 QUESTIONS

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* 6. TODAY'S DATE & TIME

Date / Time

Date

Time

AM/PM

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* 7. COVID Q1: Are you experiencing symptoms consistent with COVID-19 including fever of 100.4 degrees or higher or chills, persistent cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, nausea or vomitting, diarrhea, or loss of taste/smell?

Yes

No

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* 8. COVID Q2: Without social distancing or wearing a mask, have you been within six feet of a sick person with COVID-19 for 15 minutes or more in the past 14 days and/or are you actively caring for a person sick with COVID19?

Yes

No