5th Annual: Get Burly Leadership Academy and Team Building Retreat 
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    Event Registration

    I hereby consent to and authorize the use and reproduction by you and anyone authorized by you, of any and all photographs or other types of images, voice recordings and/or video that you have this day taken of me or recorded, with or without my name, for any purpose whatsoever, including, without limiting the promotion and activities of and for Get Burly, LLC and its affiliates.

    Additionally: The World Health Organization has declared the novel Coronavirus (COVID-19) a worldwide pandemic. Due to its capacity to transmit from person-to-person through respiratory droplets, the government has set recommendations, guidelines, and some prohibitions which Get Burly, LLC adheres to comply. In consideration of my participation in the foregoing, the undersigned acknowledge and agree to the following:
    I am aware of the existence of the risk on my physical appearance to the venue and my participation to the activity of the Organization that may cause injury or illness such as, but not limited to Influenza, MRSA, or COVID-19 that may lead to paralysis or death. I have not experienced symptoms that of fever, fatigue, difficulty in breathing, or dry cough or exhibiting any other symptoms relating to COVID-19 or any communicable disease within the last 14 days. I have not, nor any member(s) of my household, traveled by sea or by air, internationally within the past 30 days. I have not been, nor any member(s) of my household, diagnosed to be infected of COVID-19 virus within the last 30 days.

    Following the pronouncements above I hereby declare the following:
    I AM FULLY AND PERSONALLY RESPONSIBLE FOR MY OWN SAFETY AND ACTIONS WHILE AND DURING MY PARTICIPATION AND I RECOGNIZE THAT I MAY BE IN ANY CASE BE AT RISK OF CONTRACTING COVID-19. WITH FULL KNOWLEDGE OF THE RISKS INVOLVED, I HEREBY RELEASE, WAIVE, DISCHARGE GET BURLY, LLC, ITS BOARD, OFFICERS, INDEPENDENT CONTRACTORS, AFFILIATES, EMPLOYEES, REPRESENTATIVES, SUCCESSORS, AND ASSIGNS FROM ANY AND ALL LIABILITIES, CLAIMS, DEMANDS, ACTIONS, AND CAUSES OF ACTION WHATSOEVER, DIRECTLY OR INDIRECTLY ARISING OUT OF OR RELATED TO ANY LOSS, DAMAGE, INJURY, OR DEATH, THAT MAY BE SUSTAINED BY ME RELATED TO COVID-19 WHILE PARTICIPATING IN ANY ACTIVITY WHILE IN, ON, OR AROUND THE PREMISES OR WHILE USING THE FACILITIES THAT MAY LEAD TO UNINTENTIONAL EXPOSURE OR HARM DUE TO COVID-19. I AGREE TO INDEMNIFY, DEFEND, AND HOLD HARMLESS THE ORGANIZATION FROM AND AGAINST ANY AND ALL COSTS, EXPENSES, DAMAGES, LAWSUITS, AND/OR LIABILITIES OR CLAIMS ARISING WHETHER DIRECTLY OR INDIRECTLY FROM OR RELATED TO ANY AND ALL CLAIMS MADE BY OR AGAINST ANY OF THE RELEASED PARTY DUE TO INJURY, LOSS, OR DEATH FROM OR RELATED TO COVID-19.
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    I, THE UNDERSIGNED, EXPRESSLY AGREE TO INDEMNIFY, SAVE AND HOLD HARMLESS GET BURLY, LLC FROM ANY LIABILITY, CLAIMS, CAUSES OF ACTION, LITIGATION EXPENSES, ATTORNEY FEES, LOSSES, DAMAGES OR COSTS I MAY INCUR AS THE RESULT OF ANY SUCH CLAIM, POTENTIAL CLAIM, OR CAUSE OF ACTION ASSERTED BY ME IN CONNECTION WITH INJURY, LOSS, DEATH, OR ADVERSE HEALTH IMPACT RELATED TO COVID-19. I EXPRESSLY AND IN ALL CASES WAIVE AND RELEASE ANY CLAIM AGAINST GET BURLY, LLC FOR ANY INJURY OR HARM TO ME IN CONNECTION WITH INJURY, LOSS, DEATH, OR ADVERSE HEALTH IMPACT RELATED TO COVID-19.


    By signing below I acknowledge that I have read the foregoing Liability Release Waiver and understand its contents; that I am at least eighteen (18) years old and fully competent to give my consent and if not a parent and or legal guardian is giving consent on my behalf; That I have been sufficiently informed of the risks involved and give my voluntary consent in signing it as my own free act and deed with full intention to be bound by the same, and free from any inducement or representation. This waiver will remain effective until laws and mandates relevant to COVID-19 are lifted. 
    In order to be officially registered, you must complete the following steps.

    1. Fill out the above form and click Register Now.
    ​2. Click Pay Now and complete the payment.  
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