Screening Draft - Pro Court & Fitness

Screening/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.

Pro Court & Fitness has put in place preventative measures to reduce the spread of COVID-19; however, the Club cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending the Club could increase your risk and your child(ren)’s risk of contracting COVID-19.

If you're 18 and older, please skip Parent Name.

Event Name *

Event Date *

Parent Name

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Last

Student/Camper/Player *

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Last

Phone *

Email *

Please watch the video in the link: Steps Before Entering

In the last 14 days have you traveled outside your normal, daily routine?

Have you or anyone in your household had any of the following symptoms in the last 21 days: sore throat, cough, chills, body aches for unknown reasons, shortness of breath for unknown reasons, loss of smell, loss of taste, fever at or greater than 100 degrees Fahrenheit

Have you been exposed to someone being tested for COVID-19 or who has symptoms compatible with COVID-19?

Are any members of your household a close contact on quarantine for exposure to COVID-19?

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 the MHA 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 MHA may result from the actions, omissions, or negligence of myself and others, including, but not limited to, MHA 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 MHA or participation in MHA programming (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the MHA, 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 MHA, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any MHA program.

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