Name
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Please enter your legal name as written on your state ID or Passport. This will be helpful to us when booking your travel.
First Name
Last Name
Pronouns
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Gender Identity
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Date of Birth
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MM
DD
YYYY
Phone
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Please provide a phone number that we can reach you at to coordinate pick-ups upon your arrival in Albany
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Instagram
Personal Website
What is your preferred T-shirt size?
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Please list any allergies you may have.
Please list any dietary restrictions you may have.
Please list any food/snacks requests.
We take food very seriously! During our week-long opening retreat, we'll be sharing all our meals together and would like to be conscious of peoples food desires. (Don't be shy!) We will not be able to honor everyone's snack request but... let us know!
Is there anything else you would like us to know about your dietary needs??
Do you have any special concerns or needs regarding housing accommodations?
What about accessibility needs? Please identify any that you would like us to be conscious of.
Feel free to share anything else that may contribute to enhancing your overall sense of safety.
I understand that in the event that should I test positive for COVID-19 while during the training and on site, I will be asked to remove myself from shared space and will willingly do so for the health and safety of others as well as myself.
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I understand that, even when the reported risk of contracting COVID-19 is diminished, it may still be present and significant.
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I accept the potential increased risk of contracting COVID-19 if I choose to participate in this gathering.
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WAIVER OF LIABILITY: COVID-19
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed 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 have, in some locations prohibited the congregation of groups of people.
YOUTH FX (the "Company" ) has created protocols and put in place preventative measures to reduce the spread of COVID-19; however, the Company cannot guarantee that you will not become infected with COVID-19. Further attending the Company's event may increase your risk of contracting COVID-19.
By accepting this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to, or infected by COVID-19 by attending any Company event 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 to or infected by COVID-19 at Company events may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Company employees, and other participants.
I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself including, but not limited to, personal injury, disability, and death, illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur. I hereby agree to indemnify, defend, release, covenant not to sue, discharge, and hold harmless Company, its employees, agents, and representatives, of and from any and all claims, including all liabilities, claims, actions, damages, costs or expense of any kind arising out of or relating thereto. I understand and agree that this release includes any claims based on the actions, omissions, or negligence of Company, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participating and/or attending any Company event.
I also agree to follow all safety guidelines and stated protocols as as well as any other protocols mandated by state jurisdiction or facility at which we are gathering.
ACKNOWLEDGMENT of COVID-19 Waiver of Liability
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Emergency Name
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First Name
Last Name
Emergency Phone
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Emergency Email
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