Web Content Viewer
Actions

COVID-19 Waiver and Indemnification Form

COVID-19 Waiver and Indemnification Form

COVID-19 can result in serious illness or death and can be easily spread from person to person. COVID-19 was declared a worldwide pandemic by the World Health Organization. As a result, both the federal government and the State of Ohio recommend social distancing and prohibit the congregation of groups of people.

By signing this agreement, you acknowledge the contagious nature of COVID-19 and, on behalf of yourself, your personal representatives and your heirs, hereby assume all risks and all responsibility, and agree to release the Ohio Department of Public Safety, including its members, employees, officers and/or agents from any illness, injury or death that may occur, including those caused solely or in part by the negligence of the Ohio Department of Public Safety, including its members, employees, officers and/or agents, or any other person, including yourself, as well as any costs, judgements or settlements which may be brought or entered against them as a result of your personal interaction.