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COVID-19 Screening, Assumption of Risk, and Waiver of Liability Form - Parent/Guardian

Given the COVID-19 environment, The Fortis Academy is requiring all athletes to adhere to the following safety guidelines and provide the below information in order to reduce the risk or spread of infection.

Parent(s) or guardians must acknowledge the following statements to resume training with The Fortis Academy. Please initial next to each statement.

I am providing the following information on behalf of .

My athlete has not had contact with anyone confirmed with COVID-19 in the past 14 days. At any point in the future, if I have reason to believe my athlete has come into contact with someone with COVID-19, I agree to immediately notify The Fortis Academy staff.

My athlete is not currently experiencing a fever over 100, difficulty breathing, sore throat, or cough. At any point in the future, if my athlete has any of these symptoms, I will notify The Fortis Academy staff immediately. I agree to not allow my athlete to participate in any training sessions with these symptoms, and wait at least seven days after symptoms have subsided to return to training or provide Fortis with a COVID-19 negative test.

My athlete has not had any of the following symptoms in the last 14 days: fever greater than 100 degrees, difficulty breathing, or cough.

If your athlete has any of the following underlying health conditions or your athlete lives with someone with these conditions, you should continue a virtual training program:

Chronic heart disease
Chronic lunge disease
Chronic kidney disease
Moderate to severe asthma
Obesity Diabetes Reside with a family member with high risk underlying conditions
Other underlying conditions

I have read the information and answered the questions above to the best of my ability. I agree to continue to adhere to the above safety guidelines as long as I participate in Fortis Academy training.

Assumption of Risk and Waiver of Liability Relating to COVID-19

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. However, there remain many unknowns about COVID-19, how it spreads, and its impact on athletes.

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending Fortis Academy training sessions and activities and that such exposure or infection may result in severe illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at Fortis may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Fortis employees, contractors, volunteers, and program participants and their families.

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at Fortis Academy or participation in Fortis Academy programming (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless The Fortis Academy, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of The Fortis Academy, its employees, contractors, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Fortis Academy program.

Please fill out this form separately for each athlete you have participating in our training programs.

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May 2, 2020 9:11 pm EDT

COVID-19 Screening, Assumption of Risk, and Waiver of Liability Form - Parent/Guardian Uploaded by Josh Levine - josh@thefortisacademy.com IP 66.147.244.172