COVID Waiver - Medical Booking Form

COVID Waiver

  1. I agree that I am personally responsible for my safety and actions while attending a Monroe Institute residential course (hereinafter, “Monroe”). I hereby agree to comply with all Monroe policies and rules, including but not limited to all Monroe policies, guidelines, signage, and written and verbal instructions.

  2. I acknowledge and understand that COVID-19 is a contagious disease, spread from person to person. I recognize and agree that Monroe is open to use by other individuals, and I understand that therefore I may be exposed to increased risk of contracting COVID-19.

  3. With full awareness and appreciation of the risks involved, I, for myself and on behalf of my family, spouse, heirs, estate, executors, administrators, assigns, and personal representatives, hereby forever release, waive, discharge, and covenant not to sue the Monroe, its board members, officers, agents, employees, volunteers, independent contractors, affiliates, successors, and assigns (collectively the “Released Parties”) from any and all liability, claims, demands, actions and causes of action whatsoever, directly or indirectly arising out of or related to any loss, negligence of the Released Parties, any third-party using Monroe, or otherwise, while participating in any activity while in, on or around Monroe, and while using any Monroe facilities, equipment or materials (whether they are sponsored by Monroe or a third party).

  4. I hereby agree to indemnify, defend and hold harmless the Released Parties from and against all costs, expenses, damages, claims, lawsuits judgements, losses, and/or liabilities (including attorney fees) arising either directly or indirectly from or related to any and all claims made by or against any of the Released Parties due to bodily injury, death, loss of use, monetary loss, or any other physical or non-physical injury from or related to my use of Monroe facilities, equipment, or materials, whether caused by negligence of the Released Parties or otherwise specifically related to COVID-19.

  5. By signing either electronically or in-person below, I acknowledge and represent that I have read the foregoing Waiver of Liability, understand it and sign it voluntarily as my own free act and deed, including without limitation the Release of Liability and Indemnification requirements contained in this document; I am sufficiently informed about the risks involved in being at Monroe to decide whether to sign this document; no oral representations, statements, or inducements apart from the foregoing written agreement, have been made; I am at least eighteen (18) years of age and fully competent; and I execute this document for full, adequate, and complete consideration fully intending to be bound by the same. I agree that this Waiver of Liability shall be governed by and construed in accordance with Virginia law, and that if any of the provisions hereof are found to be unenforceable, the remainder shall be enforced as fully as possible and the unenforceable provision(s) shall be deemed modified to the limited extent required to permit enforcement of this waiver of Liability as a whole.