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PLEASE ANSWER THE FOLLOWING QUESTIONS
*
Indicates required field
Traveler Name
*
First
Last
1. Have you traveled outside the U.S. or to/from a highly infected region in the past 21 days?
*
Yes
No
2. Have you been diagnosed with COVID-19 in the last 21 days?
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Yes
No
3. Have you or anyone in your household experienced any of these COVID-19-related symptoms listed below in the last 14 days?
*
Yes
No
a. Known temperature of 38 C/100.4 F or higher
b. Cough (excludes symptoms from a pre-existing condition)
c. Shortness of breath/difficulty breathing (excludes symptoms from a pre-existing condition)
d. Chills
e. Muscle pain
f. Sore throat
g. Recent loss of taste or smell
4. Have you been denied boarding by an airline due to COVID-19 exposure in the last 14 days?
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Yes
No
5. Have you had close contact with someone who tested positive for COVID-19 in the last 14 days?
*
Yes
No
If you or anyone in your party who is from the same household answered YES to any of the above questions, we ask that you reschedule your trip
.
Please note that proof of vaccination against COVID-19 may be required to board your flight or to enter some destinations. Soirée Travel Specialists is not responsible for your compliance or noncompliance with any such requirements.
Have you been fully vaccinated against COVID-19?
*
I prefer not to answer
No
Yes
WAIVER AND RELEASE
By signing below you acknowledge and agree that:
(1) You have been made aware of inherent travel risks via the Soirée Travel Specialists Terms & Conditions, and you understand and acknowledge that any person-to-person interaction carries risks associated with the transmission of the Covid-19 virus and you explicitly assume such risks during your travel event.
(2) You have been provided guidelines ahead of your travel and will accept where applicable in person upon commencement of trip guidelines on the basis of advice from health authorities which may include the wearing of face masks or coverings, guidance on hand hygiene and avoiding physical contact.
(3) You have been advised of and will be asked to adhere to recommended hygiene procedures, such as traveling with and wearing a face mask and/or gloves when asked to do so, or limiting physical contact with guests not in your immediate family wherever possible.
(4) Prior to departure, you agree to periodic or regular temperature checks and to complete a pre boarding questionnaire or declaration confirming you have familiarized yourself with health and safety guidelines and requirements related to your travel event.
(5) You have been informed about support available if questions or concerns arise.
(6) You represent and warrant that you have truthfully answered the above questions in the negative; and
(7) You acknowledge and understand that Soirée Travel Specialists together with local and international health or government authorities will enforce steps mandated to reduce the risk of disease transmission, including that individuals shall maintain at least a six foot distance from other individuals whenever possible, that you wash your hands with soap and water for at least twenty seconds as frequently as possible or use hand sanitizer, that it is recommended that you wear face masks and gloves as protection and you agree to abide to the foregoing and with any such mandated steps as imposed by Soirée Travel Specialists, now and in the future, in the conduct of your travel event.
(8) You acknowledge and understand that in order to re-enter the USA, Federal Law states that you must attest that you have received a negative pre-departure test result for COVID-19. That the test was a viral test that was conducted on a specimen collected from you during the 3 calendar days preceding the flight’s departure. Or you must attest that you have recovered from COVID-19 in the last 3 months (90 days) prior to your return to the USA, or the time period specified in current CDC guidance, after having previously tested positive for SARS-CoV-2 and have been cleared for travel by a licensed healthcare provider or public health official. The requirement applies to passengers fully vaccinated against COVID-19. USA citizens and legal residents returning from
US territories and possessions such as Puerto Rico and the US Virgin Islands are exempt. The cost of any testing is the responsibility of the traveler.
In consideration of Soirée Travel Specialists, their guests, or their suppliers, permitting you to participate in your travel event, or otherwise engage in person-to-person interaction with you, you do hereby knowingly and voluntarily forever release and hold Soirée Travel Specialists and its shareholders, managers, employees, contractors, successors or assigns, and agents (collectively, the "Released Parties") harmless from any and all liability, claims, actions or damages, including without limitation, claims for negligence, property damage, personal injury or
wr
ongful death, which you or your family or any of your representatives, heirs, successors or assigns may have, or which may hereafter accrue, as the result of, relating to or arising from you participating in your travel event or otherwise engaging in person-to-person interaction with any of the Released Parties. You acknowledge and agree that but for the execution of this Waiver and Release, Soirée Travel Specialists would not allow you the participation in your travel event, or the access and interaction described herein. By executing this Waiver and Release you knowingly and willfully accept all risks related to or arising from all such activities and interaction.
Name of Person Affirming the Above Questions and Acknowledging the Waiver & Release
*
Today's Date
*
Thank You!
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