Public Speaking Workshop

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Email*

Enter Email Confirm Email

Cellular Phone*

Referral Name

Would you like to make phone calls into Georgia?*

Yes
No

Would you like to deploy to Georgia?*

Yes
No

Are you available to join us Dec. 27, 2020 through Jan. 1, 2021?*

Yes
No

Would you like to stay for more time?*

Yes
No

If you would like to stay longer, which dates would you like to arrive and depart?*

If these dates don’t work for you, what dates are you available?*

List your arrival date and departure date.

Are you driving or flying?*

I am driving.
I am flying.

If you are flying, what is your preferred departure airport?*

Do you have TSA PreCheck?*

Yes
No

Would you prefer to work in Georgia, as part of official staff?

Yes
No

COVID-19 Waiver*

I agree.

The coronavirus, COVID-19, has been declared a world-wide pandemic and is believed to spread mainly from person-to-person contact.

The Maryland Republican Party (“MDGOP”) is aware of the dangers of COVID-19 and will be following the social distancing guidelines recommended by the World Health Organization (“WHO”); however, the MDGOP cannot guarantee that participants will not become infected with COVID-19.

By signing this agreement, you represent with the best of your knowledge and belief that you do not currently have COVID-19 or symptoms of COVID-19 (such as sore throat, fever, difficulty breathing, etc.) and that you have not been exposed to someone with COVID-19 within the past fourteen (14) days.

By signing this agreement, you acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that you may be exposed to or infected by COVID-19 by attending the MDGOP deployment event and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death.

I voluntarily sign this waiver.

Waiver and Release*

I agree.

Because this event involves travel and staying overnight at a hotel, there are possible risks that could harm either you or your property. You agree that if you participate in the Maryland Republican Party’s (“MDGOP”) deployment event, scheduled for December 2020 – January 2021, that you are doing so voluntarily and assume all risk of injury, illness, and/or death. The MDGOP is not responsible for any loss, damage, or disappearance of your personal property.

This waiver and release of liability includes, without limitation, all injuries which may occur, regardless of negligence, as a result of: (a) your travel to and from the deployment event; (b) your stay at the hotel or place of lodging for the deployment event; or (c) any and all activities that you participate in as a part of the deployment event. This waiver also includes any negligence associated with the presence of or transmission of any bacteria, viruses, or infectious diseases.

By signing below, you acknowledge that you have carefully read this “waiver and release” and fully understand that it is a Release of Liability. You expressly agree to release and discharge MDGOP, and all affiliates, employees, agents, representatives, successors, or assigns, from any and all claims or causes of action and you agree to voluntarily give up or waive any right that you may otherwise have to bring a legal action against the MDGOP for negligence, personal injury, or property damage. You also agree that this waiver and release applies to any family members.

You further agree to follow all state and federal laws and understand that breaking any state or federal laws can lead to being removed from the event, being sent home, and/or criminal sanctions.

You further agree that if a court of law finds any part of this agreement to be against public policy or in violation of any state statute or legal precedent, then only that portion of the document may be deleted and the remainder of this waiver and release will remain in full force.

We filled all slots in less than 30 minutes! We have a waitlist in case a slot opens. Add yourself to the waitlist by signing up for a time slot below.