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Scottish Rite Auditorium, Genetti Hotel, Susquehanna Valley Event Center, Bears Picnic Events, etal.,
Williamsport, PA
Event: December 30/31 2022 with Cabinet
IN CONSIDERATION of being permitted to, observe, work, or participate in any way in the EVENT(S),
I for myself, my personal representatives, heirs, and next of kin: 1. Affirm that I have not been diagnosed
with, demonstrated any symptoms of or have in any way been exposed to any communicable diseases
(including but not limited to the virus commonly referred to as COVID-19) within the past thirty days;
2. Acknowledge that I am aware that by entering the premises and participating in the EVENT(S) that
there are risks to me and to those with whom I interact physically and of exposure, directly or
indirectly, to communicable disease(s) including but not limited to the virus “severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2)”, “COVID-19” and/or any mutation or variation thereof; 3.
HEREBY voluntarily agree to RELEASE, WAIVE, DISCHARGE and COVENANT NOT TO SUE on
behalf of myself or on behalf of others with whom I interact, the promoters, owners, participants,
vendors, sanctioning organizations or any subdivision thereof, officials, medics, rescue personnel, any
persons in any RESTRICTED AREA, promoters, sponsors, advertisers, owners and leasees of premises
used to conduct the EVENT(S), premises and event inspectors, surveyors, underwriters, consultants and
others who give recommendations, directions, or instructions or engage in risk evaluation or loss control
activities regarding the premises or EVENT(S) and each of them, their directors, officers, agents and
employees, all for the purposes herein referred to as “Releasees”, from all liability to the undersigned,
his personal representatives, assigns, heirs, and next of kin for any and all loss or damage, and any
claim or demands therefor, whether caused by the negligence of the Releasees or otherwise; 4.
HEREBY agree to INDEMNIFY AND SAVE AND HOLD HARMLESS the releasees and each of them
from any loss, liability, damage, or cost they may incur arising out of or related to my injury, illness or
death, whether caused by the negligence of the Releasees or otherwise. 5. *In addition, if I am purchasing
tickets for others that will attend with me, each person is included in this waiver for this purchase and will sign
the waiver at the gate. In addition, If, despite this release, a minor under my care makes a claim against
any of the "Releasees" named above, I AGREE TO DEFEND. INDEMNIFY AND SAVE AND HOLD
HARMLESS THE RELEASEES and each of them from ANY LITIGATION EXPENSES, ATTORNEY
FEES, LOSS, LIABILITY, DAMAGE, OR COST THEY MAY INCUR DUE TO THE CLAIM MADE
AGAINST ANY OF THE "RELEASEES" NAMED ABOVE, WHETHER THE CLAIM IS BASED ON THE
NEGLIGENCE OF THE RELEASEES OR OTHERWISE. I HAVE READ THIS COMMUNICABLE
DISEASE RELATED HOLD HARMLESS, RELEASE, WAIVER OF LIABILITY, AND INDEMNITY
AGREEMENT, UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL
RIGHTS BY PURCHASING TICKET(S) AND SUCH SERVES AS MY SIGNATURE; THAT I SIGN IT
FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE OR GUARANTEE BEING
MADE TO ME AND INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE
OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW. THIS AGREEMENT IS
GOVERNED BY THE LAWS OF PENNSYLVANIA, AND IS EFFECTIVE THE DATE OF TICKET PURCHASE.
Legible Signature _______________________________________________. Date ___________________

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