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City of Cleveland

dominique.green@cityofclevelandms.com

100 North Street, PO Box 1439, Cleveland, MS, 38732, US

662-846-1471

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    • 1 Signer1

    • 2 Dominique Green

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Statement of Waiver of Liability and Assumption of Risk Related to Coronavirus/COVID-19


On March 11, 2020, the World Health Organization declared the novel coronavirus, COVID-19, a pandemic. COVID-19 is highly contagious and known to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and the wearing of face coverings.

By planning a Special Event in the City of Cleveland, you acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that you and your attendees may be exposed to or infected by COVID-19. Additionally, you agree to abide by the guidance established by the Center for Disease Control, the State of Mississippi and the City of Cleveland to protect attendees and staff.

You also acknowledge that the risk of becoming exposed to or infected by COVID-19 may result from the actions, omissions, or negligence of yourself and/or others. You agree to assume all the foregoing risks, waive liability against the City of Cleveland and any other listed parties, and accept sole responsibility for any illness, injury, disability, or death to you or your attendees, including all claims that may arise resulting from any of these.
Please check that you agree before continuing.
By continuing I agree that I am willing to complete a digital version of the document(s) and that information about my user session will be stored. In addition, such acknowledgment includes your understanding and acceptance of the above COVID-19 statement.
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12/02/2021Click to Sign
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12/02/2021

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