I certify that I, and anyone listed in my reservation, will NOT attend any in-person First Congregational Church of Darien (FCCD) service or program at any time now or in the future if I/we:

(1) am/are infected with COVID-19;
(2) have, in the past 14 days, been in direct contact with any person who is infected with COVID-19;
(3) have an above-normal temperature or other symptoms of COVID-19; and/or
(4) have in the past 14 days, travelled to any area that, pursuant to the current regional travel advisory, requires self-quarantining upon return to Connecticut.

I also certify that I will not permit my minor children to attend any in-person FCCD service or program if they similarly have been exposed to the risk of or may be infected by COVID-19.

Further, I certify that if I, or anyone listed in my reservation, test positive for COVID-19 within 14 days after attending any in-person FCCD service or program, I will immediately notify FCC Administrative Assistant Dennis Hanlon by email (dhanlon@uccdarien.org) or by phone (203-655-0491 ext. 102) so that confidential precautions and contact tracing may occur, in order to avoid the further infection of others.

I recognize that COVID-19 is an extremely contagious disease that can lead to severe illness and death and that an inherent risk of exposure to COVID-19 exists in any public place where people are present.

I acknowledge that FCCD cannot guarantee a COVID-19-free environment, and I, on my own behalf and on behalf of those in my reservation, including my minor children, voluntarily assume all risks related to exposure to COVID-19 while on FCCD property or while participating in any FCCD service or program.

I agree that I will follow all FCCD established rules of conduct relating to any program or service.

I acknowledge that FCCD offers many remote services and programs that allow me to participate without my physical presence at FCCD.

In consideration for receiving permission to participate in-person in any FCCD service or program, whether offered at FCCD’s property or elsewhere, I, on my own behalf and on behalf of those listed in my reservation, including my minor children, waive, release, and agree to hold harmless FCCD and its related-entities, affiliates, employees, volunteers, trustees, agents, and representatives (collectively “Releasees”), from any and all liability or claim relating in any respect to COVID-19.

I specifically acknowledge that I am, on my own behalf and on behalf of those listed in my reservation, including my minor children, waiving and releasing any claim for negligence by the Releasees that has occurred in the past or may occur in the future.