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GoffstownAthletics.com

Goffstown School District

GoffstownAthletics.com

Goffstown School District

Announcements and Important Events

Announcement

8 months ago @ 10:12AM

Covid 19 Waiver Form

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, and has resulted in the declaration of a national emergency by the President of the United States and a state of emergency by Governor Sununu. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact with carriers sometimes being asymptomatic. 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. The Goffstown School District has put in place preventative measures to reduce the spread of COVID-19; however, the Goffstown School District cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending Goffstown School District facilities and participating in school-sponsored functions, events, or programs, including but not limited to athletics and other extracurricular activities, could increase your risk and your child(ren)’s risk of contracting COVID-19.

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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 Goffstown School District facilities and participating in school functions, events, or programs 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 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Goffstown School District employees, agents, representatives, 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 Goffstown School District facilities or participation in Goffstown School District functions, events, or programs (“Claims”). On my behalf, and on behalf of my children and our heirs, assigns, and personal representatives, I hereby release, covenant not to sue, and discharge, and agree to defend, indemnify, and hold harmless the Goffstown School District, its employees, agents, representatives, and volunteers, 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 Goffstown School District, its employees, agents, representatives, and volunteers, whether a COVID-19 infection occurs before, during, or after attending any Goffstown School District facilities or participating in school functions, events, or programs.

 

                                                                                                                                                           

Signature of Parent/Guardian                            Emergency Phone Number                               Date    

 

           

                                                                                                                                                           

Print Name of Parent/Guardian                                                 Name of Participant (STUDENT/CHILD)

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