EXTRA CURRICULAR ACTIVITIES PARTICIPATION AGREEMENT
USD No. 500 cannot prevent students from becoming exposed to, contracting, or spreading COVID-19 while participating in school activities. While USD No. 500 will take necessary precautions and comply with guidelines from federal, state and local governments, the CDC, KDHE as well as KSHSAA, it is not possible to prevent against the presence of the disease. Therefore, students who choose to participate in school activities may be exposed to and/or increase their risk of contracting or spreading COVID-19.
In consideration of being allowed to participate in USD No. 500 athletic programs or other extracurricular activities and events, the undersigned acknowledges, understands and agrees that:
Participation includes potential for exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist;
I willingly agree to comply with the stated rules, guidelines, terms and conditions for participation to protect against infectious diseases including, but not limited to:
Screenings for COVID-19 signs and symptoms, including a daily temperature check, prior to any practice, event, or team meeting with participation in the activity being limited and/or prohibited where an individual displays positive responses or symptoms.
Social distancing and healthy hygiene practices such as hand washing, using hand sanitizer.
Wearing masks/face coverings at all times except when directly participating in the activity.
I willing agree that if I observe or become aware of any unusual or significant hazard during my presence or participation to include my own health condition, including feeling sick or having an elevated temperature above 99 degrees, I will remove myself from participation and bring such to the attention of the nearest official immediately;
I willingly agree that should I test positive for COVID-19, I must obtain written clearance by a medical provider before returning to participation;
I willingly agree to abide by all rules and policies of USD No. 500 and KSHSAA;
I acknowledge receipt of the written guidance and recommendations provided by the Unified Government Public Health Department regarding students who engage in extracurricular activities;
I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and
I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE USD No. 500 their board members, officers, administrators, coaches, employees and/or agents, as well as other participants, agents, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
I HAVE READ THIS PARTICIPATION AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IF FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
Signature:______________________________________________Date____________________
Nam (printed): __________________________________________________________________
I am the parent or legal guardian of the minor named above. I have the legal right to consent to and, by signing below, I hereby do consent to the terms and conditions of this Release.
Signature:_______________________________________________ Date:__________________
Name(printed):__________________________________________________________________
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