In-person Event Participation Acknowledgement

Due to the Coronavirus (COVID-19), the Dayton Area Chamber is taking the prescribed precautions and establishing appropriate guidelines when having in-person events or activities with our members / customers. The purpose of this document is written acknowledgement of both the Dayton Area Chamber’s and individual participant’s understanding of the extended health & safety protocols in place at our chamber events / activities.

Dayton Area Chamber's enhanced measures will include:

  • All locations holding in-person activities will be properly cleaned and disinfected using prescribed guidelines;
  • Availability of hand sanitizer and / or disinfectant wipes;
  • Masks provided to participants who do not have one;
  • Seating / table set up clearly marked and adequately spaced for social distancing.

By submission of this form, you agree to the following:

In consideration of my participation in this Dayton Area Chamber event, I acknowledge and affirm the items below.  I am fully and personally responsible for my own safety and actions while and during my participation.  The Dayton Area Chamber cannot be held liable for any exposure to the COVID-19 virus caused by misinformation provided by the participants.  With full knowledge of the risks involved, I release the Dayton Area Chamber of Commerce, its Board, officers, independent contractors, and employees from any and all liabilities that may be sustained by me while participating in the aforementioned event or activity that may lead to unintentional exposure to COVID-19.

As a participant, I:
 - as well as all members of my household, do not currently have, nor have experienced COVID-19 symptoms in the last 14 days;

  - have not knowingly been exposed to anyone diagnosed with COVID-19 in the last 14 days;

  - have not knowingly traveled to / from any regions, states, or countries designated restricted by public authorities in the last 14 days;

  - will follow social distancing guidelines;

  - will refrain from social norms of handshaking, hugging, etc.;

  - will wash hands frequently;

  - will wear a mask or face covering in all common, public areas as required;

  - will take my temperature at home, prior to attending the event / activity and affirm it is under 100.4.

Fields marked with an * are required.

Please verify that you have checked the “I'm not a robot” checkbox.

In consideration of my participation in this Dayton Area Chamber event, I acknowledge and affirm the items below.  I am fully and personally responsible for my own safety and actions while and during my participation.  The Dayton Area Chamber cannot be held liable for any exposure to the COVID-19 virus caused by misinformation provided by the participants.  With full knowledge of the risks involved, I release the Dayton Area Chamber of Commerce, it’s Board, officers, independent contractors, and employees from any and all liabilities that may be sustained by me while participating in the aforementioned event or activity that may lead to unintentional exposure to COVID-19.

As a participant, I:
 - as well as all members of my household, do not currently have, nor have experienced COVID-19 symptoms in the last 14 days;

  - have not knowingly been exposed to anyone diagnosed with COVID-19 in the last 14 days;

  - have not knowingly traveled to / from any regions, states, or countries designated restricted by public authorities in the last 14 days;

  - will follow social distancing guidelines;

  - will refrain from social norms of handshaking, hugging, etc.;

  - wash hands frequently;

  - wear a mask or face covering in all common, public areas as required;

  - will take my temperature at home, prior to attending the event / activity and affirm it is under 100.4.

Powered By GrowthZone
MENU