S&F Athletes Application

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RELEASE FROM LIABILITY

I give permission to be interviewed, recorded, photographed, videotaped and or filmed by representative S and F Athletes and affiliates for purposes of publication, display and broadcast (print, web, digital display and all other forms of media). • The data and information collected on me is maintained in a secure computer database and case file. This information is used by S and F Athletes and affiliates to document services provided to youth and families for tracking and reporting purposes. S and F Athletes and Affiliates may use the information to update service information, provide closure, follow-up information, evaluate and determine the effectiveness of the programs. I authorize S and F Athletes and Affiliates to maintain the information provided for the purposes noted above in the S and F Athletes computer database and case file. • I will not be compensated for any time spent volunteering, nor am I entitled to benefits, including employment insurance benefits upon the termination of this agreement or service. • I hereby release and discharge S and F Athletes, its officers, employees, agents, affiliates and contractors from all actions, claims or demands that I, my heirs, guardian and legal representative’s now have or may have in the future for injury or damage resulting from my participation in the programs. • If I am injured do the time I am volunteering for S and F Athletes programs, Affiliates and or events. I am not covered by S and F Athletes worker’s compensation program. I authorize S and F Athletes and Affiliates to seek emergency medical treatment on my behalf in case of injury, accident or illness to me arising from my involvement as a volunteer. I understand that I will be responsible for medical costs incurred by such accident, illness or injury. • The materials, documents and supplies are the property of S and F Athletes and I agree to return all materials, documents and supplies upon the end of my volunteer services.

Liability Release Waiver for Covid-19

Due to the outbreak of the novel Coronavirus (COVID-19), S and F Athletes is taking extra precautions with the care of every client to include health history review and enhanced sanitation/disinfecting procedures in compliance with CDC guidance. People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. People with these symptoms listed below may have COVID-19: This list does not include all possible symptoms. CDC will continue to update this list as we learn more about COVID-19.

I agree to the following:

I affirm that I, as well as all household members, have not knowingly been exposed to anyone diagnosed with COVID-19 within the past 14 days. I affirm that I, as well as all household members, have not traveled outside of the country or to any City considered to be a “hot spot” for COVID-19 infections within the past 14 days. I affirm that in the past 14 days. I have not been within 6 feet of anyone that has active or suspected Covid-19 infection for over 15 minutes within a 24-hour period. I affirm that I have not had any temperatures over 100.4F (38 degrees C) or shaking chills in the last 24 hours. I affirm that I am not having shortness of breath right now or difficulty breathing. I affirm that I am not feeling dizzy or disoriented at this time. I affirm that I am not experiencing any persistent chest pressure or pain. I affirm that I have not noticed any bluish discoloration on my lips or face in the last 24 hours. I affirm that I have not had an unexplained cough in the last 24 hours. I affirm that I am currently able to walk and move around normally. I affirm that I have not noticed any new skin lesions on my legs, feet, or torso in the last 24 hours. I affirm that I have no unexplained runny nose, nasal congestion, or signs of cold. Please answer no if you think the symptoms is related to allergies. I affirm that I have not had any unusual headaches in the last 24 hours. I affirm that I have not had any changes to my sense of smell or taste in the last 24 hours. I affirm that I do not have a sore throat. I affirm that I have not had any excessive fatigue in the last 24 hours. I affirm that I have not had any severe unexplained muscle pain in the last 24 hours. I affirm that I have not had any unexplained nausea in the last 24 hours. I affirm that I have not had unexplained diarrhea in the last 24 hours. I affirm that I have not tested positive for Covid-19 in the past 10 days. I affirm that I do not have a Covid-19 diagnostic test with pending results. I understand that S and F Athletes, its officers, employees, agents, affiliates, and contractors cannot be held liable for any exposure to the COVID-19 virus caused by misinformation on this form or the health history provided by each client.

S and F Athletes is following theses enhanced procedures to prevent the spread of COVID-19:

• Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing and throw away the tissue after use. • Wash your hands many times a day with soap and running water or use an alcohol-based hand sanitizer (at least 60% alcohol) • Avoid touching your face, eyes, nose, and mouth with unwashed hands. • Always wear a face mask or face cover when you will be around other people. • Stay at least 6 feet (1.8 meters) apart from other people who are not in your household, even if you are wearing a mask. • Do not share personal items such as cups, eating utensils, towels, or bedding. Wash anything you have used in soap and water. • Clean all "high-touch" areas such as doorknobs, tablets, counters, and other surfaces. Use a household cleaning spray.