2020 HOLIDAY LIGHT CRUISE
Saturday, December 12, 2020 from 7:30 pm-9:00 pm
Staging begins at 6:30 pm
Name of Entry:
Contact Person: Phone:
Company/Organization: Fax:
Mailing Address: Email:
City: State: Zip:
Special Instructions / Comments:
Assumption of Risk and Waiver of Liability Relating to Coronavirus/COVID-19
The City of Eloy Community Services department has created new protocols and put in place preventative measures to
reduce the spread of COVID-19; however, the City cannot guarantee that you will not become infected with COVID-19.
Further, attending any program may increase your risk of contracting COVID-19, and may increase the risk of transmitting
COVID-19 to others.
I acknowledge the highly contagious nature of COVID-19 and voluntarily assume the risk that I, or members of my group or
organization, may be exposed to or infected by COVID-19 by participating in any way in any event, program, activity, reservation
or rental taking place at the City of Eloy Community Services facility or parks, and that such exposure or infection may result in
personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID- 19
at any of the City of Eloy Community Services facilities or parks may result from the actions, omissions, or negligence of myself
and others, including, but not limited to, City employees, volunteers, and other participants and their families.
I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself or members of my
group or organization, including, but not limited to, personal injury, disability, and death, illness, damage, loss, claim, liability, or
expense, of any kind, that they or I may experience or incur in connection with participation in any event, program, activity,
reservation or rental taking place at the City of Eloy Community Services facility. I hereby release, covenant not to sue, discharge,
and hold harmless the City, its employees, agents, and representatives, of and from any claims related to COVID-19, including all
liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I further agree to indemnify and
hold harmless the City of Eloy and its employees, agents, and representatives from any claim that may arise from or in connection
with my or members of my group or organization’s participation in any program taking place at the City of Eloy Community
Service facility, including claims related to COVID-19. I understand and agree that this release includes any claims based on the
actions, omissions, or negligence of the City, its employees, agents, and representatives, whether a COVID-19 infection occurs
before, during, or after participation in any City of Eloy Community Services program.
Signature: Date:
Mail entry to: Eloy Community Services Department
100 E. 7
th
St., Eloy, AZ 85131
Fax to: Fax: (520) 464-1426
Register online: www.eloyaz.gov/onlineregistrations
Email form: mbaldenegro@eloyaz.gov or eloyrec@eloyaz.gov.
For questions or additional information please call The Eloy Community Services Department (520) 466-7351 ext. 0
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