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414 Grant Street | Sewickley, PA | 15143 | 412.741.4550
Sewickley Presbyterian
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Waiver for Children & Youth Activities

Please complete Step 1 & Step 2

STEP 1


  • Read the following Waiver:

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 many locations, prohibited the congregation of groups of people.

Sewickley Presbyterian Church (SPC) has put in place measures to reduce the spread of COVID-19; however, SPC cannot guarantee that you or your child(ren) or others will not become infected with COVID-19. Further, attending SPC events could increase your risk and your child(ren)’s risk of contracting COVID-19.

By signing this Parental Consent, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending SPC events and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at SPC events may result from the actions, omissions, or negligence of myself and others, including, but not limited to, employees, volunteers, and program participants and their families.

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) 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 child(ren) may experience or incur in connection with my child(ren)’s attendance at SPC events or participation in SPC events & programming (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the SPC events, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses 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 the SPC, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any SPC events & programs.

STEP 2


  • Please fill out the following information.
  • All fields must be completed.
  • By hitting SUBMIT, you are consenting to this waiver.

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Church Office Hours

    Monday-Friday: closed

    Saturday: Closed

    Sunday: Closed

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414 Grant Street
Sewickley, PA 15143
412.741.4550

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