Brooklyn Letters Speech Language Pathology PLLC (hereinafter Brooklyn Letters) is a private practice offering speech language pathology, literacy, math, and other tutoring services. These services are offered in homes, in schools, and remotely.  Brooklyn Letters presents the worker as an Independent Contractor (hereinafter IC) and the worker provides these services under his or her own business name. The IC is a professional who uses his or her own professional and business methods to perform services.

On this date, the IC herein acknowledges that Brooklyn Letters client has been presented with a Covid-19 Waiver by Brooklyn Letters and said client has refused to sign their name. Brooklyn Letters does not take or accept any responsibility for the risks involved with Covid-19 when working with a client at their home or other designated location. The IC has complete autonomy in his or her decision to provide services to the client herein despite client’s refusal to sign the Covid-19 Waiver. The IC agrees to indemnify and hold harmless Brooklyn Letters, its owners, independent contractors, and employees for liabilities or losses which may result or arise out of any of the risks related to Covid-19 involved when working with this client.

Independent Contractor Name

Date

Craig Selinger

Owner of Brooklyn Letters Speech Language Pathology PLLC

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Document name: Covid-19 Waiver Refusal Indemnification and Hold Harmless Agreement

Unique Document ID: 177f06b54d435b4e158acd74bb62c9c6bd3de668

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Timestamp	Audit
January 15, 2022 9:12 am EDT	Covid-19 Waiver Refusal Indemnification and Hold Harmless Agreement Uploaded by Craig Selinger - [email protected] IP 39.44.198.117

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https://brooklynletters.com/

Audit Trail Serial# 3b8b0e9b420baecf359c1bdf60b5961e