RaceReach

First Name *

Last Name *

Email *

Have you been diagnosed with COVID-19 within the last 14 days? *

Have you been in contact with another person with COVID-19 within the past 14 days? *

Are you currently experiencing any of the following symptoms?

Cough *

Yes

No

Fever *

Yes

No

Trouble Breathing *

Yes

No

Shortness of Breath *

Yes

No

Sore Throat *

Yes

No

Loss of taste and/or smell *

Yes

No

Body Aches *

Yes

No

Additional Hold Harmless Waiver

It is my intent as a participant or player competing in the State Games sanctioned activities, while participating during activities including any pre-game or post-game activities at Sports Connection that I am agreeable to the following:

I acknowledge that I am aware that there are risks to me of exposure to directly or indirectly arising out of, contributed to, by, or resulting from:
     -An outbreak of any and all communicable disease, including but not limited to, the virus “severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)”, which is responsible for Coronavirus Disease (COVID-19) and/or any mutation or variation thereof; 

In consideration of having the opportunity to participate as either a team member or competitor, and in acknowledging that I am aware of and willing to assume the risks associated with this activity, I hereby voluntarily agree to waive, hold harmless and indemnify North Carolina Amateur Sports and its trustees, agents, volunteers and employees from any and all claims, demands, damages and causes of action of any nature whatsoever arising out of ordinary negligence which I, my heirs, my assigns or successors may have against them for, on account of, or by reason of my participation in the above activities.  I indicate my agreement to this hold harmless elective noted below.

Read through the agreement

I have read and agreed to the waiver above *

Is the participant 18 or older? *

18 or older Under 18