COVID Release Form and Waiver of Liability

| Elva Manquera |

All individuals attending in-person meetings at a Klamath Bird Observatory (KBO) facility or in-person education, outreach,  fundraising events, or field trips must 1) be “up-to-date” with COVID-19 Vaccines, including Boosters, 2) provide proof of vaccination status, and 3) fill out KBO’s Waiver of Liability (see below). Paper copies of our Waiver of Liability are also available at KBO facilities. For details about being up-to-date see COVID‐19 recommendation guidance at “Stay Up to Date with Your Vaccines Including Boosters”.

*Proof of vaccination will be required for all in-person events (see “Upload Proof of Vaccination” at the bottom of this form).

I acknowledge and understand that in order to participate in in-person Klamath Bird Observatory (KBO) events, all participants are required to 1) be “up to date” with all US Food and Drug Administration (FDA) or World Health Organization (WHO) authorized vaccinations and 2) properly wear a mask if requested by a KBO representative.

I acknowledge and understand that an inherent risk of exposure to COVID-19 exists in any place where people gather; I accept this risk within the context of the following liability waiver.

Waiver of Liability

Signature (Please print your full name to sign)
MM slash DD slash YYYY
Participant Name or for a Minor Name of Legal Guardian(Required)
Name of Minor (under 18 years old)
MM slash DD slash YYYY
Max. file size: 512 MB.
Please upload a picture or PDF of your vaccination card. Can only upload a single image. Upload additional image below.
Max. file size: 512 MB.
Upload additional photos
Max. file size: 512 MB.
Upload additional photos
 

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541-201-0866
PO Box 758
Ashland, Oregon 97520

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