CERTIFICATE OF COMPLIANCE

TO VERMONT BE SMART STAY SAFE EXECUTIVE ORDER 01-20

    I certify that I have reviewed the State of Vermont out-of-state traveler guidelines and comply with current health and safety requirements for traveling to, from and within the State of Vermont. I further certify that I understand all travelers should stay home if ill (with symptoms); maintain physical distance of at least 6' from anyone outside their household; wear a cloth mask when in public spaces; and wash or sanitize hands often.

    Name

    Email

    Phone Number

    Reservation number

    1. I certify that: a. I am traveling for essential purposes as defined by the State of Vermont; OR b. It has been at least 14 days since my traveling party received the final COVID-19 vaccine dose, and therefore my party is exempt from the testing requirements; OR c. I have traveled to Vermont from another state and received a negative COVID-19 test within three prior to my arrival in the state; OR d. I have not left the state of Vermont for any reason except essential travel in the past 14 days; OR e. I have left the state of Vermont, and upon return to the state received a negative COVID-19 test result within three days of my return; OR f. I have had COVID-19 within the last 3 months, have recovered, and currently have no symptoms.

    2. I also certify that, to my knowledge, I have not had close contact within the past 14 days with a person confirmed to have COVID-19.

    3. I also certify that I am traveling only with members of my household, am staying in a lodging property with only members of my household, and I will only gather with vaccinated individuals or one additional unvaccinated household at a time outside of my household while in Vermont.



    Waiver/Disclaimer – Release of Liability

    The novel Coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is an extremely contagious virus that spreads easily through person-to-person contact. Medical and scientific knowledge about COVID-19 continues to develop, and not all signs, symptoms or effects are known by Federal and State authorities. Federal and state authorities recommend social distancing as a mean to prevent the spread of the virus. COVID-19 can lead to severe illness, personal injury, permanent disability, and death. Participating in programs at the Stoweflake Mountain Resort and Spa/Baraw Enterprises (“Resort”), or accessing the Resort's facilities could increase the risk of contracting COVID-19. The Resort in no way warrants that COVID-19 infection will not occur through participation in the Resort's programs or accessing the Resort's facilities.

    By signing this agreement, I acknowledge the contagious nature of COVID-19, acknowledge the lack of complete medical and scientific knowledge about COVID-19 and its symptoms, and acknowledge that I am fully aware that myself and/or my child(ren) or ward may be at higher risk of contracting COVID-19 and may be exposed or infected by COVID-19 as a result of entering on the Resort property, open for the use of others, becoming a guest of the Resort, participating in any of its programs, occupying a room at the Resort, or using any facilities at the Resort during the COVID-19 pandemic and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I further acknowledge that I understand that the risk of becoming exposed to or infected by COVID-19 at the Resort may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Resort employees, guests, contractors, participants in activities, and others present on the Resort property despite the best of actions taken by the Resort, their staff, other guests or participants to adhere to policies, guidelines, signage and instructions.

    By signing this agreement, I agree that I voluntarily assume all of the foregoing risks and accept sole responsibility for my safety and that of my children or ward while using any of the facilities at the Resort and that myself and my children or ward will comply with all Resort policies and rules, including but not limited to all guidelines, signage, and instructions posted on the Premises.

    With full awareness and appreciation of the risks involved, I, for myself and my children, and on behalf of my children, family, spouse, estate, heirs, executors, administrators, assigns, and personal representatives, hereby forever release, waive, discharge, and covenant not to sue the Baraw Enterprises, its board members, officers, agents, servants, independent contractors, affiliates, employees, successors, and assigns (collectively the “Released Parties”) from any and all liability, claims, demands, actions, and causes of action whatsoever, directly or indirectly arising out of or related to any loss, damage, or injury, including death, that may be sustained by me or my children or my ward related in any way to COVID-19 whether caused by the negligence of the Released Parties, any third-party using the Resort, or otherwise, while participating in any activity while in, on, or around the Resort and/or while using any Resort facilities, tools, equipment, or materials.

    I, for myself, and on behalf of my children, agree to indemnify, defend, and hold harmless the Released Parties from and against any and all costs, expenses, claims, actions, damages, costs or expenses of any kind arising out of or relating to my or my children's use of the Resort, its facilities, tools, equipment or materials, whether caused by the negligence of the Released Parties or otherwise, specifically related to COVID-19.




    I have read and understand this entire Disclaimer and make the above certifications under the pains and penalties of perjury.

    Name

    Date

    Location Signed

    Please note that all persons that reside in the same household staying with us will be covered on this release for. If an individual is living in a separate household under this same reservation they must also complete this form.

    * For information related to completing this form visit accd.vermont.gov/coc.