Peninsula Community Chapel | Yorktown, Virginia
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COVID-19 Waiver

Assumption of the Risk – Indemnification – Waiver and Release

The COVID-19 pandemic has had far-reaching implications for us all. COVID-19 is a highly contagious virus, known to spread primarily from person-to-person interactions, such as through respiratory droplets, and can easily spread in group settings if someone attends who is contagious. There is much that is yet to be learned about the virus. The virus can, and for many people has, resulted in severe illness, permanent disability, or even death. As a result, federal, state, and local governments have recommended, or even required, individuals to avoid congregating with other people in many cases. While those prohibitions on church gatherings have been lifted, a number of limitations and recommendations remain. Our Church has implemented safeguards intended to reduce the spread of COVID-19, however, since COVID-19 may be spread by asymptomatic or pre-symptomatic carriers of the virus, any gathering of people at this time carries with it the inherent danger of contracting COVID-19 and suffering from the disease myself or spreading it to family or household members. No one can guarantee that you or your family, including your children, will not become exposed to or infected with COVID-19 in Church religious services or events or any other group gathering. Attending this activity could increase your, your household, and your children’s risk of contracting COVID-19 or other serious illnesses.

In light of these risks, consideration for being permitted to attend religious services or events, I acknowledge and agree to the following on behalf of myself and/or my minor children:

I/we acknowledge the dangerous and contagious nature of COVID-19 and voluntarily assume the risk that I and/or my children may be exposed to or infected by COVID-19 or other serious illnesses. I also acknowledge that by attending the service or event, such exposure or infection may result in personal injury, illness, disability, property damage, financial injury, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 at the service or event may result from the actions, omissions, or negligence of myself and others, including but not limited to Church employees, contractors, volunteers, members, and participants and their families.
On behalf of myself and my children, I do release, acquit, discharge, and covenant to hold harmless and indemnify Church, its employees, officers, directors, representatives, volunteers, and activity leaders from any and all actions, damages, and liabilities arising out of contracting COVID-19 and/or arising out of any other accident, sickness, or treatment thereof, incurred by said Participant in connection with participation in Church programs or activities.

By signing this waiver and/or attending Church services or events, I am agreeing that prior to each service or event I have monitored myself, and/or my child(ren) if attending, for any signs or symptoms of COVID-19 as documented by the CDC including fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, or sore throat, and verify that participants have not tested positive for or exhibited any symptoms of COVID-19 in the last 14 days nor have I/we been knowingly exposed to anyone that has tested positive or is presumed to be positive for COVID-19 in the last 14 days.

If I later test positive for COVID-19 I will notify Church in writing so that the appropriate parties may be warned. I consent to Church notifying other church attendees about my illness and for reporting the illness state, local, or other authorities for the purpose of warning, tracing, legal defense, or response.

I agree that I will abide by CDC sanitation and social distancing protocols and applicable executive order requiring wearing a face covering when inside the Church.

I further agree to indemnify, hold the church harmless and defend Church against all claims related to COVID-19 arising out of my (and/or my child or children’s) connection to the service/event and/or for any claim that I/we knowingly or negligently spread COVID-19 to others at the service/event whether because I/we did not monitor for symptoms before attending, did not follow social distancing/face covering protocols, or otherwise. 

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Peninsula Community Chapel

4209 Big Bethel Road
Yorktown, VA 23693
T 757-867-8530
office@pccyorktown.com

Office Hours
Monday - Thursday: 8AM - 4PM
Friday: 9AM - 12PM
Saturday: Closed
Sunday: 8AM - 1PM
  • I'm New
  • Next Steps
  • Ministry
    • Children
    • Students
    • Women
    • Men
    • Home Groups
    • College
    • Worship Team
    • 60+ Seniors
    • Discipleship Classes
    • Buddy Ministry
    • Orphan Care
    • Prayer
    • Caregiver Support
    • Summer Interest Groups
    • Mercy Ministry
    • SportsWorld
    • SportsWorld Jr
    • Peninsula Fellows
    • Via Institute
  • Outreach
  • Events
  • Resources
    • Sermons
    • Worship
    • Goals
    • Forms & Documents
    • Event Support
    • KidzMin Volunteers
    • Beyond These Walls
    • Caring Well Team
    • ACW
    • Reading List
    • PCC App
    • Members
    • Photos
    • Media
    • Women's Blog
  • Give