Baby Within

From Belly
Baby & Beyond

From Belly to Baby & Beyond!

COVID-19 Waiver & Release Form

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 via person-to-person contact. As a result, federal, state, and local governments as well as federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. Baby Within has put in place preventative measures to reduce the spread of COVID-19; however, Baby Within cannot guarantee that you or your family will not become infected with COVID-19.

I understand the novel coronavirus causes the disease known as COVID-19. I understand the novel coronavirus virus has a long incubation period during which carriers of the virus may not show symptoms and still be contagious.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my family and I may be exposed to or infected by COVID-19 by visiting Baby Within place of business and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my family or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my family may experience or incur in connection with my family’s participation in a 3D ultrasound session with Baby Within. On my behalf, and on behalf of my family, I hereby release, covenant not to sue, discharge, and hold harmless Baby Within and its representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto.

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