Covid-19 Waiver & Release & Participant Notes
The novel coronavirus, COVID-19, has been declared a pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact, including individuals without disease symptoms. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited or limited the congregation of groups of people.
The health and well-being of our staff and athletes remains our top priority. In order to minimize the risk of COVID-19 entering our environment and spreading amongst our community, we will only allow staff assigned to work and athletes scheduled to participate to be in our gym. Parents wishing to remain on site can use outdoor common areas or the parking lot to wait for their athlete(s). Athletes waiting to attend a session will need to wait outside while maintaining social distance from others.
Furthermore, all participants in sponsored activities at
must agree to and abide by the following:
MAINTAIN REQUIRED SOCIAL DISTANCING PROCEDURES AND SPACING
WEAR MASKS WHEN ASKED
REFRAIN FROM UNNECESSARY PHYSICAL CONTACT
NOT ATTEND ANY ACTIVITITES IF DISPLAYING ANY SYMPTOMS OR A FEVER OVER 100.1 F.
BE CLEARED BY A PHYSICIAN PRIOR TO RETURN IN THE EVENT OF ILLNESS AND COMPLETED ANY NECESSARY TESTING PROVIDING COPIES OF TESTING CLEARANCE TO THE CLUB IN WRITING
NOTIFY THE CLUB IN WRITING OF ANY NECESSARY MEDICAL RELATED NEEDS
PARTICIPATE IN ROUTINE HAND WASHING AND ANY ADDITIONAL PERSONAL SANITIZING STEPS
BE WILLING TO PARTICIPATE IN REQUIRED FEVER TESTING PRIOR TO TRAINING
NOT SHARE ITEMS SUCH AS WATER BOTTLES
FOLLOW ANY GOVERNMENT REQUIRED APPLICABLE GUIDELINES
(hereafter referred to as the “Club”) has put in place numerous preventative measures and enhanced cleaning protocols to reduce the likelihood of spreading COVID-19 in Club’s gym environment; however, the Club cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending sponsored activities at the Club could increase your risk and your child(ren)’s risk of contracting COVID-19.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily agree to the participation terms described above and assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending the Club and that such exposure or infection may result in personal injury, illness, permanent disability, and death.
I understand that the risk of becoming exposed to or infected by COVID-19 at the Club may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Club employees, 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 the Club or participation in Club programming (“Claims”).
On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the Club, 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 Club, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Club activities. Participant Liability Release
Please review and complete the sections below and sign in the space provided to indicate your agreement with all statements made in each section. By entering a guardian/parent name above you acknowledge are agreeing to liability release for Adrenaline USA Volleyball as follows.
AUTHORIZATION AND RELEASE OF LIABILITY: I, the parent or guardian of the above-named child, authorize the participation of my child in ADREANLINE USA VOLLEYBALL I understand that this Program is a nonprofit sports ministry program for youth and that my child’s participation is voluntary and not essential to completion of requirements of any program, school, or government agency. I understand that the Program is conducted by ADRENALINE USA VOLLEYBALL and its volunteers and staff, including parents of other participating children. I also understand that ADRENALINE USA VOLLEYBALL is solely responsible for all aspects of the Program including selection and supervision of all persons conducting the Program. I further understand and agree that my child’s participation in athletic and other activities of the Program necessarily involves the risk of injury and even death from various causes, including but not limited to accidents, falls, strenuous and prolonged physical activity, dehydration, illness, collision or dispute with other participants, weather related injuries, playing area and equipment defects, and negligence of coaches and referees. On behalf of my child, me, and my family, I assume these risks. In consideration of the privilege of my child’s participation in the ADRENALINE USA VOLLEYBALL Program, and on behalf of my child and me as parent/guardian, I hereby release, discharge, hold harmless and indemnify, and covenant not to sue, ADRENALINE USA and all of the directors, officers, employees, volunteers, insurers, agents and representatives, and all other persons associated with ADRENALINE USA VOLLEYBALL (including without limitation any other participating sponsors, parents, vendors, coaches and other game and event workers, officials, drivers, and organizations) as to any and all claims of my child, me and other family members for personal injuries suffered by my child, property damage, medical expenses, and economic loss arising directly or indirectly out of my child’s participation in ADRENALINE USA VOLLEYBALL, and any first aid, medical care, or treatment provided to my child in the event my child is injured or becomes ill while participating in ADRENALINE USA VOLLEYBALL activities, and excepting claims that may not be released under applicable law. This Release of Liability shall be as broadly construed as allowed by law to include all claims and rights that the child, that I as parent/guardian, and that other family members may have. I am a legally responsible parent or guardian of my child. If any provision of the Release of Liability is deemed invalid, the remaining provisions shall remain in full force and effect. This Release of Liability shall be binding on me, my family, heirs, next of kin, legal representative, beneficiaries, successors, and assigns. I give permission for free use of child’s name and picture in broadcasts, telecasts, or written accounts for any participation in an ADRENALINE USA VOLLEYBALL spsored event. I affirm that this form was signed by only one parent/guardian because (1) I am the sole parent/guardian responsible for the care and custody of the child due to death or incapacity of the other parent/guardian or court order, or (2) I have made a good faith effort to obtain the signature from the other parent/guardian but have not been able to do so due to causes beyond my control, and I am not aware of any reason that the other parent/guardian objects to the child’s participation in the Program. MEDICAL CONDITIONS: I understand that participation in the Program may involve strenuous and prolonged physical activity. I agree that my child is healthy and able to participate in the Program activities. I understand that ADRENALINE USA VOLLEYBALL or its representatives may request health information concerning my child and/or ask my child to undergo a medical exam. If ADRENALINE USA VOLLEYBALL determines that my child does have a physical or mental condition that may affect his/her ability to safely and appropriately participate in Program activities, they may determine that my child cannot be permitted to participate. I understand and agree that, while the ADRENALINE USA VOLLEYBALL desires that all children will be able to participate, such decisions may have to be made out of concern or the best interest of my child and other participants. CONSENT TO MEDICAL TREATMENT: In the event my child is injured or becomes ill in Program activities, and if I, the parent or guardian of the above-named child, am not present to
make medical decisions, I hereby authorize ADRENALINE USA VOLLEYBALL, its staff, volunteers, including volunteer parent participants, coaches, assistant coaches, and referees, supervisors and drivers, to arrange for and consent on my behalf to emergency medical and dental care and treatment, including tests and radiological exams, and surgery, and hospital care and treatment, and to consent to medication for pain and other conditions as prescribed by medical personnel attending my child. I am responsible for payment of any medical charges or expenses not covered by my insurance or the insurance applicable to my child (if any). My signature below indicates that all information provided in this form is true and accurate, and that I fully agree to all statements made on the form, including but not limited to the Authorization and Release of Liability, Medical Conditions, and Consent to Medical Treatment. Each responsible parent/guardian should sign.
Player/ Participant Goals
Please let us know any individual athlete or player goals you have this season. As detailed as possible is encouraged and accepted even if general.
Additional Information
Please let us know any additional information you feel is necessary to know in advance of evaluation and acceptance to programs and membership.
