Name: January 5-8, 2023
Start: 2023-01-05T14:00:00+00:00
End: 2023-01-08T14:00:00+00:00
Location: Bethany Ocean Suites Residence Inn by Marriott

Event Dates 2022 - By typing my name 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; 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; that I give my voluntary consent in signing this Liability Release Waiver as my own free act and deed with full intention to be bound by the same, and free from any inducement or representation. You MUST select the appropriate date.

Bethany Ocean Suites

Bethany Ocean Suites

Name *

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Email *

Phone

Street Address *

City, State & Zip Code *

Please list your City, State & Zip Code

Table Mates

Please add any table mates that you would like to sit with at the event

Room Mates

Please add the name of any Room Mates you will be bunking with.

Emergency Contact *

Please list the name and phone number of the person to contact in the event of an emergency.

Policy Statement *

By checking this box, you agree to adhere to Scrapping by the Sea Cancellation and Events Policies.

Fee Paid by PayPal or Check *

Checking this box indicates that your payment has been submitted and accepted by PayPal Friends and Family to ginafries@gmail.com ONLY. Do not use the website email address for payment.

Before submitting your registration, YOU MUST PAY FOR YOUR EVENT. Please enter your PayPal conformation number here before emailing your event registration. If paying by check please put the Check Number and date mailed below. *

PayPal Friends and Family Confirmation # OR mail your check with the requested info above to: Gina Fries - 460 John Hurd Rd - Harrington, DE 19952

COVID-19 Liability Release Waiver Acknowledgment

Please read and check all mandatory boxes below. You are required to complete and submit the form along with your Event Registration.

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.

COVID Question 1 *

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.

COVID Question 2 *

I have not, nor any member(s) of my household, traveled by sea or by air, internationally within the past 30 days.

COVID Question 3 *

I did not, nor any member of my household, visit any any area within the United States that was reported to be highly affected by COVID-19, in the last 30 days

COVID Question 4 *

I have not been, nor any member(s) of my household, diagnosed to be infected of COVID-19 virus within the last 30 days.

COVID Question 6 *

With full knowledge of the risks involved, I hereby release, waive, discharge the Organization, 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.

COVID Question 7 *

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.

Following the pronouncements above I hereby declare the following: *

I have not been, nor any member(s) of my household, diagnosed to be infected of COVID-19 virus within the last 30 days.

By typing my name 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; 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; that I give my voluntary consent in signing this Liability Release Waiver as my own free act and deed with full intention to be bound by the same, and free from any inducement or representation. *

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