4-13-23- NASW-FL Northwest Unit Gathering

Registration

• This is an in-person event.

Personal Information

• * First Name:
• * Last Name:
• * Email Address:
• * Confirm Email Address:
• Address 1:
• City:
• State: --Choose-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming -------------- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
• ZIP Code:
• * Phone:

COVID Waiver

• In order to attend the Event, we require that all attendees consent to a waiver of liability related to COVID-19. Please carefully review the waiver that follows and indicate your consent below.

• I acknowledge the contagious and evolving nature of COVID-19 and voluntarily assume the risk that I may be exposed to the virus at the Event and become infected as a result. I accept sole responsibility for any potential illness or other harm to myself (and any associated expense) related to contracting the virus while attending the Event. I hereby release, covenant not to sue, discharge, and hold harmless NASW, its employees, agents, and representatives from all liability of any kind related to COVID-19. I will comply with all COVID-related policies that may be implemented by NASW and the Venue. This includes, but is not limited to, mask-wearing and social distancing requirements and restrictions on certain activities that carry higher COVID-related risk.

• *

  I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS WAIVER, AND I CONSENT TO ITS TERMS.

  • Yes
  • No

Guest Information

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