Hello everyone, please fill out the form below to register for:
Rachel Woolsey's 6th Birthday Party!
This form Must be filled out to participate.
We use this as an RSVP AND OUR MANDATORY WAIVER.
If your child is attending, please fill out.
If not attending, still fill out but place an "X" next to your last name. (John Smith-X)
Terms & Conditions
You agree that your child, attending the birthday party, is in good health and accept that all risks associated with any and all activities participated in, without risk of injury.
Covid Questions:
1. Do you have any of these symptoms that are not caused by another condition?
• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• Recent loss of taste or smell
• Sore throat
• Congestion
• Nausea or vomiting
• Diarrhea
2. Within the past 14 days, have you had contact with anyone that you know had COVID-19 or COVID-like symptoms? Contact is being 6 feet (2 meters) or closer for more than 15 minutes with a person, or having direct contact with fluids from a person with COVID-19 (for example, being coughed or sneezed on).
3. Have you had a positive COVID-19 test for active virus in the past 10 days?
4. Within the past 14 days, has a public health or medical professional told you to self-monitor, self-isolate, or self-quarantine because of concerns about COVID-19 infection?
You further understand that the activities made available involve physical exercise and confirm that you are able to participate in such effort.
You agree to release, indemnify, and hold harmless Michael Pam's Black Belt Champions, located at 701 Middle Country Road, Selden, NY 11784, all of their affiliates, subsidiaries, and each of their respective agents, representatives, officers, directors, shareholders and employees (collectively, "releases") from and against any injuries, losses, damages, claims, actions, or liability of any kind resulting, in whole or in part, directly or indirectly, from or arising from the participation in any and all activities made accessible at Michael Pam's Black Belt Champions.
You must read the terms of service in order to check out.