Page 10 - CJA High School Summer Camps

Parent Permission and COVID
Waiver of Liability for Student Participation
at Cor Jesu Academy

By signing below, I give permission for my child, ,
to participate in a 2022 summer camp at Cor Jesu Academy.
I acknowledge that federal and state government officials have declared
INITIALS that there currently exists a public health crisis in our country related to
the Coronavirus Disease 2019 (“COVID-19”).
I confirm that I will not permit my child to participate in the program or
INITIALS activity if, at any time during the program or activity, my child is showing
any symptoms of COVID-19 (including but not limited to fever, dry cough,
fatigue, shortness of breath, chills, muscle pains). Additionally, I confirm
that I will not permit my child to participate in the program or activity if
they have tested positive for COVID-19. This applies to everyone who tests
positive, regardless of vaccination status. Participants must be at least 5
days without symptoms before they can attend a camp.
I confirm that I will not permit my child to participate if they are not
INITIALS vaccinated and they were exposed to someone with COVID-19. A non-
vaccinated person can come to camps, after 5 days past the exposure if
they do not develop any COVID-19 symptoms. A vaccinated participant
that is exposed to someone with COVID-19 can attend if they do not
develop any symptoms.
I understand that Cor Jesu Academy cannot prevent the possible
INITIALS transmission or contraction of COVID-19 for my child.
The undersigned agrees to release, discharge, hold harmless and indemnify Cor Jesu
Academy, its agents, employees, officers, Board of Directors, insurers and others acting
on the school’s behalf (the “Releasees”), of and from any and all claims, demands, causes
of action and/or legal liabilities for injuries to or death of my child occurring during, or
resulting from, or participation in the above-mentioned program or activity and related
in any way to COVID-19, even if the cause, damages or injuries are alleged to be the fault
of or alleged to be caused by the negligence or carelessness of the Releasees.

Student’s Name

Signature
PARENT OR LEGAL GUARDIAN
Date

00391240.1
10