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"The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy."-Dr. Martin Luther King, Jr.

 

COVID-19 Release Form

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1. *

Please write your first and last name.

COVID-19 Release Form

Additional Liability Agreement concerning COVID-19.  The following is currently being added to the Broward County Homeschool Parent Support Group (PSG) Release of Liability.  You have already read and signed the general Release of Liability.  Please read and sign for these additional statements.  These statements are not separate from the Release of Liability.  Rather, they have been added where appropriate to the PSG Release of Liability.

I and members of my family:

  • Acknowledge that my family’s participation in PSG and my family’s utilization of the First Baptist Church of Plantation (FBCP) AND/OR Pines Baptist Church (PBC) facility could expose my family to a possible risk of personal injury, and exposure to COVID-19, and that such injury, COVID-19 exposure, etc., could lead to illness, permanent injury or death, and that I assume all risks and accept sole responsibility that is inherent in such participation and/or utilization.
  • Release and agree to indemnify and hold harmless PSG, FBCP, and PBC, which includes any PSG member, board member or volunteer, and any FBCP and PBC officers, elder, staff member, employee, volunteer, and agent from any and all liability, loss, damage, personal injury, COVID-19 exposure, and/or claims arising from my family’s participation and/or utilization, including claims that are known or unknown, foreseen or unforeseen, future or contingent.
2. *

By checking the box below, I affirm that I have read, acknowledge, agree to abide by, and have submitted the COVID-19 Release Form.

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Yes, I agree
3. 

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