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COVID-19 Waiver and Photo Upload

To attend this years event, you and your guest are required to read and sign the COVID-19 waiver.

 

We also request that you submit a headshot photo using the form below.

If there are any questions, please reach out to us at 866-292-1220 x0 or info@czerlonkaproductions.com

COVID-19 Waiver and Release

Columbian Mutual Life Insurance Company

October 15 – 22, 2021

By registering for and attending the Monarch Beach Sales Conference (the “Event”), I agree to abide by all health and safety guidelines and recommendations promulgated by federal, state and local government agencies and officials, Columbian Mutual Life Insurance Company “Company”, and the Event venue. This includes, but is not limited to, submitting to restrictions set in place during the Event that may consist of daily temperature checks, wearing a mask at all times in indoor public areas, engaging in appropriate social distancing, and restrictions on certain activities that carry higher COVID-19-related risk, such as congregating in large private gatherings or attending off-site events in crowded facilities. I further agree that I will not attend the Monarch Beach Sales Conference in person if I become ill, am exposed to the COVID-19 virus within 30 days prior to the Event or exhibit any symptoms of the COVID-19 virus prior to and during the Event.

WAIVER OF LIABILITY RELATING TO CORONOVIRUS Relating to Coronavirus/COVID-19

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is reported to be extremely contagious. The state of medical knowledge is evolving, but the virus is believed to spread from person-to-person contact and/or by contact with contaminated surfaces and objects, and even possibly in the air. Evidence has shown that COVID-19 can cause serious and potentially life threatening illness and even death. Columbian Mutual Life cannot prevent you from becoming exposed to, contracting, or spreading COVID-19 while attending the Event. It is not possible to prevent against the presence of the disease. Therefore, if you choose to attend the Event, you may be exposing yourself to and/or increasing your risk of contracting or spreading COVID-19.

 

ASSUMPTION OF RISK: I have read and understood the above warning concerning COVID-19. I hereby choose to accept the risk of contracting COVID-19 in order to attend the Event.

WAIVER OF LAWSUIT/LIABILITY: I hereby forever release and waive my right to bring suit against Company and its owners, officers, directors, managers, officials, trustees, agents, employees, or other representatives in connection with exposure, infection, and/or spread of COVID-19 related to attending the Event. I understand that this waiver means I give up my right to bring any claims including for personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen. I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS RELEASE, AND FREELY AND KNOWINGLY ASSUME THE RISK AND WAIVE MY RIGHTS CONCERNING LIABILITY AS DESCRIBED ABOVE.

Columbian's 2021 Sales Conference