Rustic Lodge Private Session Waiver

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Name* This field is required.

First Name

Last Name

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Email* This field is required.

example@example.com

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Phone Number* This field is required.

Area Code

Phone Number

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Facility Rules* This field is required.You MUST read & follow all Rustic Lodge Facility Rule.

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Rustic Lodge Covid-19 Waiver* This field is required.I fully attest to the best of my knowledge that I do not have COVID-19 at the time of attending Rustic Lodge Diving Dogs. I also attest that I have NOT been in contact with or exposed to any known carrier of COVID-19 within the past 15 days. I agree that I am attending this Rustic Lodge Diving Dogs event entirely at my own risk and take full responsibility for my own health and safety. I will follow Facility rules and requirements to reduce any exposure and possibility of contracting or spreading the virus. I will also fully cooperate with any City, County or State guidelines that have jurisdiction in the area of Rustic Lodge Diving Dogs.I fully submit that Rustic Lodge Diving Dogs, any workers, any volunteers, any sponsors, or any affiliated representation with Rustic Lodge Diving Dogs, that I am attending are in no way liable for any present or future COVID-19 exposure incurred at any time by any person, in attendance or not in attendance, during or after this Event.

6

Date

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Signature* This field is required.I hereby agree to every form, waiver, and rule that was presented in this document.