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2020-21 Athletic COVID Consent Form

READ CAREFULLY – THIS AFFECTS YOUR LEGAL RIGHTS

After reading this page, digitally sign and submit.

COVID-19 Consent: Waiver and Release

Our state and county is experiencing a Novel Coronavirus (hereinafter COVID-19) pandemic, and a public health emergency has been declared for North Carolina. the purpose of this form is to opbtain your consent to voluntarily attend/participate in 2020/2021 Arendell Parrott Academy athletic practices/games/workouts (hereinafter APA Athletics) at Arendell Parrott Academy (hereinafter APA), and you agreement to release and hold harmless APA and its trustees, officers, administratots, teachers, staff, employees, volunteers, contractos, agents, and representatives (hereinafter collectively Associates) from any and all liability directly or indirectly related to any physical and mental injury, damage or death from exposure to COVID-19.

The undersigned herby covenants and agrees not to bring any claims, demands, or causes of action for any reason related to COVID-19 exposure against APA and/or Associates resulting from participation/attendance in APA Athletics of while using any facilities in connection with such activity.

Currently, there is some increased risk associated with APA Athletics. These risks include:

  • Exposure to other attendees who may have the virus
  • Exposure to facilities that contain the virus

Patients in the following categories and with the following health conditions are at greater risk:

  • Asthma, Chronic lung disease, Diabetes, Serious heart disease/conditions, Chronic kidney disease, Severe obesity, Age 65 or older, Nursing home or long-term care facility residents, Immunocompromised or immune suppressed patients, Liver disease and Pregnancy

If you have one or more of these problems, you may be at greater risk for contracting COVID-19. If you contract COVID-19, you may be at greater risk to develop complications, including serious complications possibly leading to hospitalization and, in rare situations, death.

Alternative Choices

There are alternatives to attending APA Athletics

  • Not participating or attending in any capacity as participation/attendance are not required

Agreements and Acknowledgements

In exchange for my ability to voluntarily attend/participate in APA Athletics, for myself and (if applicable) for the members of my family (including any person fro whom I am the legal or personal guardian), I make the following agreements and acknowledgements:

  • I agree and acknowledge that it is my ersponsibility to proide for my own health and safety.
  • I agree and acknoledge that it is my responsibility to provide for the health and safety of my child or any person for which I am the legal or personal guardian who may participate in and/or attend APA Athletics
  • I assume all risk and harm associated with any potential exposure to COVID-19 that I may have, or any members of my family may have (if applicable), with participating/attending APA Athletics.
  • I agree and acknowledge that APA and Associates are not responsible for any exposure I have, or any members of my family (if applicable) may have, to COVID-19 during my participation and/or attendance at APA Athletics or while on the premises of APA.
  • I agree and acknowledge that although APA and/or Associates have made reasonable attempts to protect participants and attendees from COVID-19, it is my duty and responsibility to follow Centers for Disease Control (CDC) and local health guidelines for social distancing and other measures to reduce the spread of COVID-19.
  • I agree to maintain six (6) feet of distance between myself and any other participant or attendee to the extent possible.
  • I agree that if I feel unsafe or if I am unable to comply with CDC and local health guidelines, I will remove myself from the premises of APA.
  • I agree to wash or sanitize my hands after using the restroom, sneezing, and coughing.
  • I agree not to enter the premises of APA if I am experiencing any of the following symptoms:  nasal congestion, sore throat, muscle aches, nausea, vomiting, diarrhea, fever (>100.4F), cough and/or shortness of breath.
  • I agree not to enter the premises of APA if I reasonably believe I have COVID-19, or if I have likely been exposed to someone who has COVID-19.  For purposes of this Consent, a person who has likely been exposed to COVID-19 is defined as any person who:
    • has travelled internationally within the preceding 14 days;
    • is experiencing fever, cough, or shortness of breath;
    • has been directed to quarantine, isolate or self-monitor;
    • has a known exposure to COVID-19; or
    • resides with or has been in close contact with any person in the above-mentioned categories.  
    • Athletes may return 15 days after their first known exposure to COVID-19 (Per Dr. Keith Ramsey: Infectious Disease Specialist @ Vidant Medical Center)
    • If an athlete tests positive for COVID-19 they can return once CDC guidelines are met
  • I agree to observe and obey all posted rules, warnings and guidelines, and further agree to follow any verbal instructions or directions given by APA representatives to mitigate my potential exposure to COVID-19.
  • I agree that although APA and I are taking steps to reduce the risk of COVID-19 exposure, we cannot eliminate the risk, especially for higher risk participants/attendees.
  • I agree that participation/attendance at APA Athletics may be hazardous to my health and the health of my family (if applicable), and agree that I assume all such risk of COVID-19 exposure on my behalf and on behalf of my family (if applicable).
  • I agree that by signing below, I will comply with the written instructions above, and that failure to comply with any written instructions or any verbal instructions from APA and/or Associates while attending or participating in APA Athletics may result in my removal from the premises. 
  • I agree that by signing this Consent, I hereby release APA and Associates from all liability for claims, foreseeable and unforeseeable, arising from exposure to COVID-19, and any harm, injuries or damages I may, or my family may (if applicable), experience due to my participation/attendance at APA Athletics.
  • I agree that by signing this release, I intend to bind my spouse, next-of-kin, heirs, insurers, legal representatives, assigns, successors and anyone else claiming harm, injury or damage resulting from my exposure to COVID-19 at APA Athletics.  Therefore, this release applies to my spouse, next-of-kin, heirs, legal representatives, insurers, assigns and successors, as well as me.   
  • I agree that I am aware of the legal consequences of this consent form, including that it prevents me from suing APA and Associates for any reason related to COVID-19 and my participation/attendance at APA Athletics.  
  • I agree that in no event shall APA and Associates by liable for compensatory, punitive, incidental, consequential (including lost profits), special, or exemplary damages resulting from my exposure to COVID-19 in connection with my attendance or participation, at APA Athletics.  
  • I acknowledge that I am under no pressure or duress to sign this COVID-19 Consent: Waiver and Release.
  • I agree that this COVID-19 Consent: Waiver and Release is intended to be as broad and inclusive as permitted by North Carolina law and that it shall be governed and interpreted by North Carolina law; and further, I agree that if any portion of this consent form is held invalid, the balance shall continue in full force and effect.

 

Signature for Consent to Attend/Participate

(Initial below) The first page of this consent form told you about COVID-related risks. If, after reviewing this form, you do not believe that you reasonably understand the risks and choices, do not sign the form until you fully understand such risks and choices.

I AGREE AND ACKNOWLEDGE THAT I HAVE THOROUGHLY READ THIS COVID-19 CONSENT: WAIVER AND RELEASE, AND FULLY UNDERSTAND IT IS A RELEASE OF LIABLITY.  BY SIGNING THIS DOCUMENT, I AM WAIVING ANY RIGHT I HAVE, OR MY SUCCESSORS OR BENEFICIARIES MAY HAVE TO BRING A LEGAL ACTION OR ASSERT A CLAIM AGAINST APA AND ASSOCIATES FOR ANY HARM, ILLNESS, INJURY OR DEATH RESULTING FROM MY PARTICIPATION OR ATTENDANCE AT APA ATHLETICS.

Please select the sport the student-athlete plans on playing each season.
If he/she does not wish to play a sport in a certain season, leave it blank.
If he/she decides at a later date to play an additional sport, there is no need to complete a second form.

Fall Sports
Answer Required
Winter Sports
Answer Required
Please check the box if you also wish to participate in the Shooting Team during the winter
Answer Required
Spring Sports
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Confirmation Email