COVID-19 Assumption of Risk & Waiver of Liability
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, instituted their own requirements and guidelines. Governmental restrictions and the restrictions outlined below may change at any time without prior notice.
Missouri Mission of Mercy (MOMOM) event for 2022 has instituted the following policy for all attendees.
Guests must provide one of the following upon entry:
- An official, government-issued vaccination card (physical or mobile image accepted) listing the person's name and date the last dose was administered along with a matching photo ID. *If children between the ages of 12-17 do not have a photo ID, a parent or guardian will be required to verify their identity.
- A printed or digital negative COVID-19 PCR or rapid antigen test administered on site by a healthcare professional or pharmacy provider that includes the person's name along with a matching photo ID. Self-administered tests will not be accepted.
- Children under the age of 12 are exempt from this policy but they must be accompanied by a parent or guardian who meets the vaccination or negative test requirement.
In addition to these new protocols, all attendees over the age of 2 at the MOMOM event must continue wearing their face masks while indoors. A face mask may be removed for a brief period of time to eat or take a drink of a beverage, but when finished, attendees are expected to return their face mask to cover their nose and mouth.
MOMOM organizers cannot guarantee eligibility to travel to or to participate in the 2022 MOMOM event on July 14-16, 2022. Additionally, if MOMOM attendees choose to attend the MOMOM event and enter onto the Chaifetz Arena premises, they may be exposing themselves to and/or increasing their risk of contracting or spreading COVID-19.
MOMOM, the Missouri Dental Association, Missouri Dental Association Foundation, Chaifetz Arena, St. Louis University, Spectrum Venue Management, and the officers, directors, members, managers, agents, instructors, contractors, servants, employees and any other representation of the foregoing (collectively, the “Entities”) will seek to implement preventative measures to reduce the spread of COVID-19 consistent with the guidance and recommendations of public health agencies for slowing the transmission and exposure to COVID-19 which may include, but not be limited to, health questionnaires for all event participants, sanitation procedures, and physical distancing measures at Chaifetz Arena and during the MOMOM event.
By checking the “I Agree” box while registering, I, as a volunteer, acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by accessing the MOMOM event in-person and that such exposure or infection may result in personal injury, illness, permanent disability, and death. As such, I, as a volunteer, accept the terms of this Assumption of the Risk and Waiver of Liability.
Registrant understands that the risk of becoming exposed to or infected by COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to the Entities and other MOMOM event participants.
Registrant agrees to abide by all preventative measures outlined above (collectively “Measures”) put in place by the Entities at any time prior to and during the event including, but not limited to, wearing cloth face coverings at all times in public spaces, remaining at least six feet away from other event participants, and promptly notifying Missouri Dental Association Foundation if any registrant experiences symptoms of COVID-19 during the event. Registrant further agrees that any of the Measures may be modified or eliminated prior to the event at the discretion of the Entities and without advance notice to Registrant.
Registrant acknowledges that personal failure to follow these Measures may result in being removed from the MOMOM event and all related activities without any refund or reimbursement. Finally, Registrant acknowledges that no promises, representations, or affirmations of fact were made to me concerning the safety or danger associated with traveling to the event or participating in any activity or interaction related to or associated with the event.
MOMOM Volunteer Service Agreement—Waiver of Liability (Healthcare)
FOR HEALTHCARE VOLUNTEERS, By checking the ‘I Agree’ checkbox below, I, on behalf of myself, my heirs, executors, administrators, and assigns, in consideration of being allowed to participate as a volunteer in the Missouri Mission of Mercy (MOMOM) Event, waive any right of recovery and release the Missouri Dental Association (MDA), the Missouri Dental Association Foundation (MDAF), MOMOM, Chaifetz Arena, St. Louis University, Spectrum Venue Management, and the present and former officers, directors, members, managers, agents, instructors, contractors, servants, employees, volunteers and any successors, assigns and other representative of each of the foregoing (collectively, the “Releasees”) from liability, arising from any and all injury to persons and damage to property, including, but not limited to those which arise out of the NEGLIGENCE of any of the Releasees, and further agree and undertake to indemnify, hold harmless and defend the Releasees from and against any and all claims, damages, actions, liability and expenses including attorney’s fees and other professional fees in connection with bodily injury including death, personal injury and/or damage to property arising from or out of my activities and participation in volunteer services at the MOMOM event.
I, as a volunteer, further acknowledge and agree that none of the Releasees assume any responsibility whatsoever for my property and I shall not hold any of the Releasees liable for any loss or damage to same.
I, as a volunteer, further acknowledge and grant to the MDA and MDAF and their agents the right to use my picture, voice and other reproductions of my physical likeness in connection with advertising or publicizing MOMOM services and its activities in all forms of media in perpetuity.
I, as a volunteer, further acknowledge that I hold an active or volunteer Missouri license (or a license or registration in another state which permits me to practice in the State of Missouri) to practice in the category of professional service for which I volunteered for the MOMOM event as a dentist, oral surgeon, dental hygienist, expanded function dental assistant, physician, physician’s assistant, LPN, RN, nurse’s aide, EMT, pharmacist, or pharmacy tech or any other healthcare position.
I state and affirm that my license has not been revoked suspended or subject to probation and that I am not currently restricted from practicing the profession for which I have volunteered for the MOMOM event in any way in Missouri or in any other state in which I am licensed or registered. I also hereby state and affirm that I am not aware of any current or pending investigation relating to my license or registration to practice in Missouri or any other state in which I am licensed or registered.
I further represent and warrant to MDA and MDAF that neither I nor any entity in which I am an owner, officer, director, member, manager, or employee is excluded from participation in any federal health care programs, as defined under 42 U.S.C. Section 1320a-7b(f), or any form of state Medicaid program, and to my knowledge, there are no pending or threatened governmental investigations that may lead to such exclusion. I agree to notify MDA and MDAF of the commencement of any such exclusion or investigation within seven (7) business days of my first learning of it.
MOMOM Volunteer Service Agreement—Waiver of Liability (General)
FOR GENERAL COMMUNITY VOLUNTEERS, By checking the ‘I Agree’ checkbox below, I, on behalf of myself, my heirs, executors, administrators, and assigns, in consideration of being allowed to participate as a volunteer in the Missouri Mission of Mercy (MOMOM) Event, waive any right of recovery and release the Missouri Dental Association (MDA), the Missouri Dental Association Foundation (MDAF), MOMOM, Chaifetz Arena, St. Louis University, Spectrum Venue Management, and the present and former officers, directors, members, managers, agents, instructors, contractors, servants, employees, volunteers and any successors, assigns, and other representative of each of the foregoing (collectively, the “Releasees”) from liability, arising from any and all injury to persons and damage to property, including, but not limited to those which arise out of the NEGLIGENCE of any of the Releasees, and further agree and undertake to indemnify, hold harmless and defend the Releasees from and against any and all claims, damages, actions, liability and expenses including attorney’s fees and other professional fees in connection with bodily injury including death, personal injury and/or damage to property arising from or out of my activities and participation in volunteer services at the MOMOM event.
By checking the ‘I Agree’ checkbox below, I also grant to the MDA and MDAF and their agents the right to use my picture, voice, and other reproductions of my physical likeness in connection with advertising or publicizing the MOMOM services and its activities in all forms of media in perpetuity. Attorney’s fees and other professional fees in connection with bodily injury including death, personal injury and/or damage to property arising from or out of my activities and participation in volunteer services at the MOMOM.