
BelmontCityWaiver


General Liability Waiver
I hereby absolve the City of Belmont, its employees, independent contractors, and officers from all liability that may arise as a result of my participation in the activities above, and in the event that the above-named participant is a minor, I hereby give my permission for his/ her participation as indicated and in so doing, absolve the City of Belmont, its employees and independent contractors from such liability. I/We agree to allow use of my/participant’s photograph(s) and video(s) for Parks and Recreation program online and print publicity.
COVID-19 Athletic Field/Youth Sports Organizations
USER’S ACKNOWLEDGEMENT OF SUITABILITY OF FACILITIES
I acknowledge that as a condition of permission to use city recreation
facilities I must inspect and carefully consider the suitability of the
facilities for my use, including my participating in any program, and on
behalf of myself and attendees of an event hosted by me, I declare that
I have inspected and carefully considered the premises, equipment and
facilities, and if applicable, the affiliated program or event, and find
and accept them as being safe and reasonably suited for use and
participation by myself and my attendees.
USER RESPONSIBILITIES RELATED TO COVID-19
I agree to not participate in activities or use city facilities or
allow any attendees invited by me or on my behalf to participate in
activities or use any City facility if myself or the attendee has:
(i) tested positive for COVID-19 and has not since tested negative;
(ii) reason to suspect they may have a COVID-19 infection;
(iii) experienced a temperature of 100.4 degrees Fahrenheit or greater
or any other symptoms of COVID-19, listed at
https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html,
in the 24 hours immediately before the use of the City facility;
(iv) reason to believe that they or a member of their household has been exposed to COVID-19 within the past 14 days; or
(v) returned within the past 14 days from highly impacted areas subject
to a CDC Level 3 or Level 4 Travel Health Notice. The CDC Travel Health
Notices list is updated regularly and may include domestic and
international locations. The undersigned agrees to check the current CDC
Travel Health Notices list before using the facilities, equipment,
services, and programs of the City or hosting a private event on city
property.
I agree to notify the City immediately if I believe that any of the foregoing access/use restrictions may apply.
I agree and will require all vendors and guests associated with my
rental, to comply with the guidelines provided by the California
Department of Public Health and the County of San Mateo Public Health
Officer and the City’s protocols for private gatherings in effect at the
time of the gathering.
ASSUMPTION OF RISK FROM COVID-19
I
am aware of the COVID-19 pandemic and related governmental orders,
directives and guidelines (collectively “directives”), including
directives for frequent hand washing, social distancing and use of face
masks in public locations. I am aware that city facilities are a public
location at which I may be exposed to COVID-19 and therefore that use
these facilities is a hazardous activity. I am aware that I could be
infected, seriously injured or even die due to COVID-19. I am aware that
the city cannot protect me from contracting COVID-19 while using city
facilities. I acknowledge that I am assuming all responsibility for
protecting myself from COVID-19 while using city facilities. I am
voluntarily choosing to use city facilities with knowledge of the danger
involved and agree to assume sole responsibility for any and all risks,
known or unknown, of exposure to or injury from COVID-19 associated
with or attributable directly or indirectly to use of city facilities or
participation in city events.
HOLD HARMLESS and RELEASE OF LIABILITY
On behalf of myself and my assigns, personal representatives and heirs,
I forever release and discharge the City of Belmont, and its elected
officials, officers, employers and agents (collectively “releases”) from
any and all actions, claims, causes of action and liability, including
claims of negligence whether passive or active, that in any way relate
to or arise from the COVID-19 pandemic and use of city facilities and
agree and promise not to assert any claim or bring any action against
the releases that is in any way connected with the COVID-19 pandemic and
the use of city facilities.