EmailMe Form - Cross Country COVID-19 Release Form 2020

Student Name *

First Last

Parent Name *

First Last

Parent Cell Phone *

### - ### - ####

Parent Email *

Location:

Parkview Baptist School

COVID-19 Statement of Understanding

I have read the COVID-19 guidelines and my selection and initials indicate that I understand that:

Check each of the following for acknowledgement

To minimize contact and comply with social distancing guidelines, parents will remain in their cars, in the parking lot

Faculty, staff, and students must stay at home if they are sick, have symptoms or have been exposed to COVID-19 within the last 14 days

All particpating in the event will be checked for fever and will be sent home if a fever is registered at 100 degrees or higher

I understand that this is NOT a mandatory event and I give permission for my child to attend

Please Initial *

I understand my child is REQUIRED to follow the directives of the PBS personnel exactly as given and that the school rules must be followed as outlined in the Student Handbook and in accordance with the specific COVID-19 precautions.

INDEMNIFICATION: I release and waive, and further agree to indemnify, hold harmless or reimburse the board of trustees, the individual members, agents, employees and representatives thereof; including trip chaperones, form and against, any claim that I, any other parent or guardian, any sibling, my child, out of, during, or concerning my child's participation in the trip or the rendering of emergency, medical procedures, or treatment, if any.

Informed Consent

I knowingly and willingly give my informed consent for my child to participate in this event and specifically consent to his/her participation in associated activities.

Parent Initial *

Parent Signature *

Clear

Student Signature *

Clear

Date Time *

MM / DD / YYYY