Student Name *

First Name

Last Name

Parent or Guardian Name *

First Name

Last Name

Parent or Guardian Phone *

(###)

###

####

Which Class? *

U-18 or Summer Camp

Other CSz Class

Private or School Event

Enrollment Status *

I have a confirmed registration

I am on the Wait List

I am just showing up

I don't know

Have you or anyone in your household had any of the following symptoms in the last 10 days: sore throat, cough, chills, body aches for unknown reasons, shortness of breath for unknown reasons, loss of smell, loss of taste, fever at or greater than 100 degrees Fahrenheit? # *

# That are not CLEARLY caused by another condition

No

Yes - I will not participate and will check for future class dates

Have you had a positive COVID-19 test for active virus in the past 10 days, or are you awaiting results of a COVID-19 test? * *

No

Yes - I will not participate and will check for future class dates

Within the past 10 days, has a public health or medical professional told you to self-monitor, self-isolate, or self-quarantine because of concerns about COVID-19 infection? *

No

Yes - I will not participate and will check for future class dates

Proof of Vaccination *

Yes - I have emailed my Vax Card to patrick@portlandcomedy.com

Yes - I am carrying proof with me

No - I will not be able to participate

Booster

Yes, I have had a booster

I plan to get a booster soon

I am not boostered. Is booster a verb?

COVID 19 TERMS AND CONDITIONS *

These terms and conditions relate to an individual’s use of a booking to gain admittance to The CSz Portland Arena and possible exposure to the novel coronavirus SARS- CoV-2 and any resulting disease (together with any mutation, adaptation, or a variation thereof, “COVID-19”): COVID-19 WARNING AND WAIVER OF CLAIMS: WHILE CSZ PORTLAND EVENT PARTICIPANTS, PERFORMERS, AND TICKETING SERVICE PROVIDER ARE DOING OUR PART TO ENSURE THE HEALTH AND SAFETY OF EVERYONE IN THE ARENA, AN INHERENT RISK OF EXPOSURE TO COVID-19 EXISTS IN ANY PLACE WHERE PEOPLE GATHER, SO WE CANNOT GUARANTEE THAT ALL EXPOSURE TO COVID-19 WILL BE ELIMINATED AS A RESULT OF THESE PROTOCOLS. COVID-19 IS A HIGHLY CONTAGIOUS DISEASE THAT CAN LEAD TO SEVERE ILLNESS AND DEATH. BY VISITING OR ENTERING THE VENUE, YOU ASSUME ALL RISKS, HAZARDS, AND DANGERS INCIDENTAL TO THE EVENT FOR WHICH THE BOOKING IS ISSUED. YOU VOLUNTARILY WAIVE ANY AND ALL CLAIMS AND POTENTIAL CLAIMS AGAINST CSZ PORTLAND, EVENT PARTICIPANTS, AND PERFORMERS, AND EACH OF THEIR RESPECTIVE EMPLOYEES, AGENTS, AFFILIATES, OFFICERS, DIRECTORS, OWNERS, VENDORS AND CONTRACTORS, THAT ARISE FROM OR RELATE IN ANY WAY TO, HOWEVER CAUSED, THE RISK OF CONTRACTING OR THE ACTUAL OR ALLEGED CONTRACTING OF COVID-19, OR THAT ARISE FROM OR RELATE IN ANY WAY TO, HOWEVER CAUSED, THE RISK OF EXPOSURE OR ACTUAL OR ALLEGED EXPOSURE TO A BACTERIA, VIRUS OR OTHER PATHOGEN CAPABLE OF CAUSING COVID-19 OR ANY OTHER COMMUNICABLE DISEASE OR ILLNESS, IN EACH CASE WHETHER THE ACTUAL OR ALLEGED CIRCUMSTANCES GIVING RISE TO ANY CLAIM OCCUR BEFORE, DURING, OR AFTER THE EVENT.

I Agree

Inclusion & Personal Safety *

We are all here to take care of each other and make each other look good. CSz Portland is dedicated to the concept that Comedy is For Everyone. All are welcome at our shows and in our classes. We welcome all ages, all abilities, all identities, all orientations, all backgrounds. ComedySportz® Matches are rated E for Everyone. We offer ratings for our other shows so that all audiences can be aware of the content. We offer separate classes for adult, teens/tweens and families, so that everyone can feel comfortable. If, at any time, you feel unsafe, uncared for, bullied or harassed by anyone involved with CSz Portland, please let us know - email to patrick@portlandcomedy.com or by using our anonymous contact app: https://app.suggestionox.com/r/vvDHHN Your submission to this app is completely anonymous until YOU DECIDE it's OK for us to know who you are. The app link and information are available at the bottom of every CSz Class Email.

I understand

General Waiver *

As a CSz Class or Workshop Participant, realize that my personal behavior is directly related to my safety. I agree that VIEWERS LIKE YOU , LLC, DBA ComedySportz–Portland, and Patrick Short and Ruth Jenkins, have no responsibility for any personal injury sustained during a ComedySportz class or workshop. Viewers Like You, LLC assumes no liability for any injury which above said workshop participant may sustain during a class workshop. I acknowledge that I freely choose to participate in the workshop activities, and am free, at any time, to decline to participate in any activity, provided I do not interfere with the free choice of others to participate or not participate, or disturb those who choose to participate.

I agree

Publicity Waiver *

I give permission to ComedySportz-Portland, and/or parties designated by ComedySportz-Portland to photograph the person named below and use such photographs in all forms of media, for any and all promotional purposes including advertising, display, audiovisual, exhibition or editorial use. I further consent to the use of the name of the person named above in connection with the photographs if needed by ComedySportz-Portland. I understand that there will be no financial compensation for my time or expenses for this consent to photograph or use of the person's name and release Viewers Like You, LLC dba ComedySportz-Portland from any claims.

I agree

I do not wish to participate in any photo or video

We have a Denial of Publicity - do not disclose that the participant is in this class.

Alternate Parent or Guardian Phone

(###)

###

####

Consent for Medical Treatment of a Minor *

I give my permision for members of the CSz Portland staff to seek emergency medical and surgical treatment in the event that such treatment becomes necessary. I grant my permission for treatment by a licensed physician and the physician’s assistants and designees, including such hospital or urgent care personnel as the licensed physician may deem necessary. The minor named in this consent document may receive all treatment provided according to generally accepted standards of medical practice.

I agree