COVID-19 Waiver COVID 19 Waiver Full Name* Email* Phone*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands I agree to isolate from the commencement of my participation in the shoot until the conclusion.* Yes No I will instead provide a second negative covid test one week following my first.* Yes Waiver* I agree to the following:Screenwise is committed to providing and maintaining a safe and healthy workplace for all workers, contractors and authorised attendees involved in the Production at the Location. Screenwise will issue you health and safety guidelines to follow that are based on best practice and advice from relevant Government health and work safety authorities. However, the unprecedented, and at times still unknown, nature of COVID-19 means that any activity and work requiring human interaction carries with it an inherent risk. Workers compensation and travel insurances maintained by Screenwise may not cover loss and damage caused by a pandemic. For example, you of course have the right to bring a workplace injury or workers compensation claim for contracting COVID-19 at work if your work activities are proven to be the main contributing factor to you contracting COVID-19. However, if it cannot be established that your employment contributed to your contraction of the virus (as may be the case if there is widespread community transmission of the disease), then such an injury may not be covered under relevant compensation schemes. It is in these latter circumstances that Screenwise cannot be liable for any loss or expenses that attendees incur as a result of you contracting COVID-19. While Screenwise will make its best efforts to ensure a safe and healthy work environment, signing this document will act as an acknowledgement that you understand and accept the inherent risk of involvement in the Production during this time and release Screenwise from any liability that may arise if you are exposed to or contract COVID-19 during the period of time when you are also working on the Production. This release of liability is only to the extent allowable by relevant work health and safety laws, as explained above. You will also acknowledge and accept that not only do you have a duty to take reasonable care of your own health and safety, but also a duty not to adversely affect the health and safety of others. If you wish not to participate in the Production, the Screenwise respects this decision. Should you have any queries in relation to the above, please contact Screenwise on 02 9281 4484.Agreement* I agree to the following:This document is intended to be legally binding. The consideration for the declarations and acknowledgements provided by you is constituted by the agreement by the Production Company to engage your services on the Production. By submitting this document I declare all of the above to be true and correct at the time of signing and that I do not currently have any of the symptoms associated with the COVID-19 or similar. I hereby agree; To comply with all of the Production Company’s policies and procedures relating to COVID-19 as notified to me; I agree to arrange private transport to and from the production at my own expense, and acknowledge that travel by public transport will be considered a breach of self-isolation; That the Screenwise will not, to the extent allowed by relevant work health and safety and workers compensation laws, be liable for any damage, loss or injury occasioned to me in connection with exposure to COVID-19 or any other COVID-19-related incident relating to the Production; To release the Screenwise from any such claim as described above, whether brought by myself or on my behalf; Not to make any public statement about any COVID-19-related incident relating to the Production and/or Screenwise, unless it is necessary or appropriate to make a report to a statutory authority; or otherwise interfere with or impair the production, distribution, advertising or promotion of the Production; and It is understood that my sole remedy in the event of any breach of this Deed by Screenwise shall be an action at law for damages, if any.