Robotics Fellows Course Apr 11-12, 2022 RSVP and COVID Vaccination Attestation Name(Required) First Last Email(Required) Please let us know which of the two courses you are able to/prefer to attend:(Required) Monday, April 11, 2022 (Arrive Sunday, depart Monday evening) Tuesday, April 12, 2022 (Arrive Monday, depart Tuesday evening) Available for either course I am unable to attend either course Sorry to hear that! Thank you for your RSVP.(Required) I acknowledge that I am removing myself from the invitation list for this particular course I understand that SAGES has a COVID vaccine mandate in place for all attendees, faculty, and staff, and I attest that I am fully vaccinated (including a booster).(Required)"fully vaccinated" is defined by including a booster dose Yes, I am or will be fully vaccinated more than 2 weeks prior to the date of the course No, I am not and/or will not be vaccinated more than 2 weeks prior to the date of the course Please acknowledge that you understand by not accepting our vaccine mandate that you will be removed from this course and replaced immediately by a wait listed applicant.(Required) I acknowledge that I am removing myself from the invitation list for this particular course I acknowledge and agree that SAGES and all other sponsors of this event, and their directors, officers and employees are not responsible for any illness, hospitalization, death, damages, medical expenses, liabilities, or loss of any kind that I may suffer relating to my attendance at the SAGES Robotics Fellows Courses. By issuing this acknowledgement and accepting these terms, I, for myself, and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release, indemnify, and hold harmless SAGES and all sponsors of the SAGES Robotics Fellows Courses, its officers, officials, agents and/or employees (“collectively, the releasees”), from any and all claims, demands, losses, and liability arising out of or related to any illness, hospitalization, death, damages, medical expenses, liabilities, or loss of any kind that I may suffer by attending the Robotics Fellows Courses.(Required) Yes, I acknowledge and agree No, I do not agree Please acknowledge that you understand by not accepting the release of liabilities that you will be removed from this course and replaced immediately by a wait listed applicant.(Required) I acknowledge that I am removing myself from the invitation list for this particular course