COVID-19 FACILITIES RIDER AND RELEASE AGREEMENT
Community: LAKESIDE BEACH CIVIC ASSOCIATION (the “Association”)
I, for myself, and any minor identified below, agree to the following as a supplement to any other agreements required
to access, reserve, rent, or use facilities:
1) Use of Community Facilities – I agree that entry upon or use of any property owned, managed, or controlled
by the Association including any common area property, amenities, or recreational facilities (the “Property”) is at
my/user’s own risk. I further agree to follow all of the Association’s rules and policies while at the Property.
2) COVID-19 Orders, Rules, and Guidance. I acknowledge that orders, rules, and guidance provided by
governmental agencies and the Centers for Disease Control (“CDC”) provide recommendations and mandatory rules
that require, among other things: (1) social distancing; (2) occupancy limit enforcement; (3) cleaning and disinfection;
(4) restricted entry of facilities by persons who have COVID-19 symptoms or have been diagnosed with COVID-19;
and (5) other requirement specific to certain activities or facilities (“Regulatory Requirements”).
3) Responsibility for Management. I acknowledge that I am responsible for compliance with any Regulatory
Requirements and enforcing compliance by users or guests during my period of use of the Property. I acknowledge
that I am also responsible for cleaning and disinfecting high touch surfaces and any equipment used both before and
after my period of use (at the commencement of my use of the Property and at the time I depart the premises).
4) Release. I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my family,
including child(ren), and I may be exposed to or infected by COVID-19 while on site at the Property and that such
exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand that the
risk of becoming exposed while on site at the Property may result from the actions, omissions, or negligence of myself
or others, including, but not limited to, the Association, its agents, employees, mangers, directors, officers, and
representatives. I, on my own behalf and any minor identified below, agree to hold harmless and release the
Association, and its agents, employees, managers, directors, officers, and representatives, from any and all claims,
causes of action, injury or illness, including infection due to COVID-19, arising out of or relating in any way to my
entry upon or use of Property. I understand and agree that this release includes any claims, causes of action, injury or
illness, including infection due to COVID-19 based on the actions, omissions, or negligence the Association, and its
agents, employees, managers, directors, officers, and representatives.
On behalf of any minor(s) identified below, I represent that I am a legal guardian, and all releases and
acknowledgements provided herein shall apply to the minor(s).
AGREED AND ACCEPTED:
PRINTED LEGAL NAME:________________________
SIGNATURE: ___________________________________
DATE:_____________________________
FOR ANY MINOR(S):
PRINTED LEGAL NAME:_____________________________________
PRINTED LEGAL NAME:_____________________________________
PRINTED LEGAL NAME:_____________________________________
PRINTED LEGAL NAME:_____________________________________
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