2026 Certifying (Part 2) Examiner Waiver
AMERICAN BOARD OF UROLOGY
Waiver and Release of Liability for Communicable Disease
The American Board of Urology (herein ABU) has taken preventative measures to reduce the spread of communicable disease including, but not limited to COVID-19 (“Communicable Disease”) at its Oral Examination (the “Exam”). However, I acknowledge that ABU cannot guarantee that I will not be exposed to or contract a Communicable Disease at the Exam. Further, due to the nature of the facilities, services and programs offered at this Exam, I understand that attending the Exam could increase my risk of contracting a Communicable Disease. In consideration of being allowed to participate in the Exam, I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, acknowledge and agree as follows:
A. Adherence to Communicable Disease Protocols. I agree to abide by all applicable COVID-19- related requirements, advisories, policies, procedures, and protocols of the hotel, testing facility and ABU, as well as the CDC, the State of North Carolina, and any other governmental authority for the duration of my participation in the Exam, including, without limitation, requirements related to hand sanitation, social distancing, and face masks/face coverings. I understand and agree that my continued noncompliance with stated protocols after warning may result in my expulsion from the Exam without re-entry and without reimbursement of any fees I have paid to attend.
B. Symptoms or Exposure to COVID-19. I understand and agree that I will abstain from attending the Exam or coming into contact with any Exam participant if on the day of the exam (1) I am currently experiencing or have experienced in the 5 days prior to the Exam any symptoms of COVID-19, (2) I have had a positive COVID-19 test within 5 days of the Exam, or (3) I have had close contact with an individual who has been diagnosed with COVID-19 within 5 days before the start of the Exam and I am unvaccinated.
C. Waiver and Release. I hereby release, covenant not to sue, discharge, and hold harmless from, and waive on behalf of myself, my heirs, and any personal representatives, the Releasees, with respect to any and all liabilities, claims, penalties, suits, demands, judgments, costs, interests and expenses (including attorneys’ fees and costs) that may be caused by any act, or failure to act, by the Releasees, or that may otherwise arise in any way in connection with my attendance at the Exam. I understand that this Release discharges the Releasees from any liability or claim that I, my heirs, or my personal representatives may have against the Releasees with respect to any bodily injury, illness, disability, medical treatment, or property damage that may arise from, or in connection to, my attendance at the Exam, as a direct or indirect result, in whole or in part, of a Communicable Disease, to the fullest extent permitted by law.
D. Assumption of Risk. I understand the risk that I may be exposed to or infected by a Communicable Disease by attending the Exam and that such exposure or infection may result in quarantine requirements, serious illness, permanent disability and/or death. I further understand that the risk of becoming exposed to or infected by a Communicable Disease at the Exam may result from the actions, omissions or negligence of myself and others, including, but not limited to, ABU, its officers, board members, employees, contractors, agents, representatives, sponsors, other participants, and any owners and lessors of premises used to conduct the Exam (“Releasees”). I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, BOTH KNOWN AND UNKNOWN, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, and assume full responsibility for my participation in the Exam. I agree that I have no right to remuneration or other compensation for participation in the Exam.
E. Covenant Not to Sue. I will not initiate any claim, lawsuit, court action, or other legal proceeding or demand against the Releasees, nor join or assist in the prosecution of any claim for money or other damages which anyone may have, on account of injuries (including death), losses, or damages sustained by me or by anyone else who contracts a Communicable Disease from me in connection with my participation in the Exam.
F. Governing Law and Forum. I expressly agree that this Waiver and Release is intended to be as broad and inclusive as permitted by the laws of the State of Virginia, and that this Waiver and Release will be governed by and interpreted in accordance with the laws of the state of Virginia without giving effect to its conflict of laws rules. I agree that in the event that any clause or provision of this Waiver and Release is held to be invalid by any court of competent jurisdiction, the invalidity of that clause or provision will not affect the remaining provisions of this Waiver and Release, which will continue to be enforceable. I agree that any dispute arising out of or relating to my attendance at the Exam or any enforcement of this Waiver and Release shall be resolved exclusively in the state or federal courts for Albemarle County, Virginia, and I expressly submit and consent to the jurisdiction of such courts and waive any defense of inconvenient forum.
Certifying (Part 2) Examination Recording Disclosure and Attestation
I authorize the American Board of Urology (ABU) to record the video and audio of my performance during the ABU oral examinations for educational, quality, and scoring purposes. All examination related data are the property of the ABU and remains confidential. Videos and survey responses may be used for the purpose of quality control and research to improve the examination methodology and delivery. Such recordings will be retained in accordance with ABU retention policies. I acknowledge and agree that I have no rights to or ownership interest in the video or audio of my performance. I understand and acknowledge that any use by me of a mobile or recording device during an ABU examination may result in my examination being invalidated and the loss of my registration fee. Furthermore, if I attempt to record, transmit, or transcribe any portion of the examination, my examination will be invalidated, and I will forfeit my registration fee. In addition, the ABU reserves the right to prosecute those responsible under all applicable state and federal laws, including but not limited to copyright laws.
I HAVE READ THIS WAIVER AND RELEASE OF LIABILITY/ATTESTATION AND THIS EXAMINATION RECORDING DISCLOSURE AND ATTESTATION, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I MAY BE GIVING UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY.
