Assumption of the Risk and Waiver of Liability Relating to Coronavirus/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. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.
In accordance with the most recent protocols and guidance issued by the World Health Organization, the Center for Disease Controls, the Georgia Department of Public Health and executive orders issued by the Governor of the State of Georgia, Fort Valley State University Upward Bound Program has put in place preventative measures to help reduce the spread of COVID-19; however, we cannot guarantee that you, your child(ren) and/or your family will not be exposed to or contract COVID-19.
In consideration for allowing my child(ren) to participate in the Fort Valley State University Upward Bound program, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren), family and I may be exposed to or contract COVID-19 by attending Upward Bound's on-site or off-site activities, classes, and other events. I understand that the risk of becoming exposed to or infected by COVID-19 at Fort Valley State University's- Upward Bound Program may result from the actions or omissions of myself and others, including, but not limited to, Upward Bound's 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) , family and myself including, but not limited to, bodily injury, disability, death, illness, medical treatment or loss of any kind, that may arise from or in connection with my child(ren)’s attendance at Fort Valley State University or participation in Upward Bound's on-site or off-site activities, classes, and other events.
On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless Fort Valley State University, the University System of Georgia, the Georgia Board of Regents, the Upward Bound Program, including each entity’s directors, 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 Fort Valley State University's- Upward Bound Program, its governing board, directors, employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in the Upward Bound Program's on-site or off-site activities, classes, and other events.
Further, I agree, represent and warrant that:
(1) My child(ren) is not experiencing any symptoms of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell;
(2) My child(ren) has not traveled internationally within the last 14 days;
(3) I do not believe my child(ren) has been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19;
(4) My child(ren) has not been diagnosed with Coronavirus/Covid-19;
(5) My child(ren) will not participate in the Upward Bound program nor enter an Upward Bound class, activity or associated facility within 14 days of:
(a) traveling to a highly impacted COVID 19 area designated with a travel advisory of 3 or higher;
(b) coming in contact with any person returning from highly impacted areas with a travel advisory of 3 or higher; or
(c) exposure to any person who has a suspected or confirmed case of COVID-19; o
(6) If my child(ren) experiences any symptoms of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell, my child(ren) will discontinue participation in the Upward Bound program until symptoms have subsided for 14 days. Further, if my child is diagnosed with COVID 19, I will notify the Upward Bound program of said diagnosis.
I HAVE FULLY READ AND VOLUNTARILY SIGN THIS ASSUMPTION OF RISK, RELEASE AND WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT AND FURTHER AGREE THAT NO ORAL REPRESENTATIONS, STATEMENTS OR INDUCEMENT APART FROM THE FOREGOING WRITTEN AGREEMENT HAVE BEEN MADE. I AM AWARE THAT BY AGREEING TO THIS AGREEMENT I AM GIVING UP LEGAL RIGHTS INCLUDING THE RIGHT TO RECOVER DAMAGES FROM FORT VALLEY STATE UNIVERSITY, UPWARD BOUND AND THEIR AFFILIATES IN CASE OF INJURY, ILLNESS, DEATH OR PROPERTY LOSS OR DAMAGE INCLUDING THOSE INJURIES IN CONNECTION WITH COVID-19. I UNDERSTAND THAT THIS DOCUMENT IS A PROMISE NOT TO SUE AND A RELEASE OF AND INDEMNIFICATION FOR ALL CLAIMS. I ALSO UNDERSTAND THAT THIS AGREEMENT IS MADE ON BEHALF OF MY MINOR CHILD(REN) AND/OR LEGAL WARDS AND I REPRESENT AND WARRANT THAT I HAVE FULL AUTHORITY TO SIGN THIS AGREEMENT ON BEHALF OF SUCH MINOR(S).