Please complete this form after you have signed up for a St. Johns Volleyball Class Online.
* All information submitted is private and will be kept for our records and to easily contact you if needed.
In consideration of being allowed to participate in any way in the program, related events and activities, I the undersigned, acknowledge, appreciate, and agree that:
1. The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist and,
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES, BUT NOT GROSS NEGLIGENCE OF THE RELEASES; or others, and assume full responsibility for my participation; and,
3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately and,
4. The novel coronavirus known as COVID-19 (and its variants) is extremely contagious and as a result, federal, state, and local governments and federal and state health agencies recommend social distancing. They have, in many locations, prohibited or limited the congregation of groups of people. The health and well-being of our class players and all high school staff along with camp staff remain our top priority. To minimize the risk of COVID-19 (or any of its variants) entering our class environment and spreading amongst the class environment community, we are recommending only camp staff assigned to work at the class and class players scheduled to participate be at the location where the class is held. Furthermore, we are recommending the following participation terms to all participants in Volleyball1on1 Class: Frequently wash your hands. Wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Apply sanitizer to entire hands (back and front) and rub your hands together until they feel dry. Avoid touching your eyes, nose, and mouth. Avoid close contact with others. Cover coughs and sneezes. Wear a mask. Volleyball1on1 cannot guarantee that your child or you will not become infected with COVID-19 (or any of its variants) while attending the St. Johns Volleyball / Volleyabll1on1 Class. By signing this Volleyball1on1 Summer Camp 2022 Medical Information & Parental Consent and Waiver, I acknowledge the contagious nature of COVID-19 (and its variants) and hereby grant permission for my child(ren) to participate in the Volleyball1on1 Class and voluntarily agree to the participation terms described above. I understand that the risk of becoming exposed to or infected by COVID-19 (or any of its variants) while at the location where the class is held may result from the actions, omissions, or negligence of myself and / or others, including, but not limited to, Volleyball1on1 employees and contractors, school employees, coaches, volunteers, and program participants and their families. I also understand that my child(ren)’s participation in the Volleyball1on1 class could itself cause injury to my child(ren) or me. I voluntarily agree to assume all foregoing risks and accept sole responsibility for any injury to my child(ren) or myself, including, but not limited to, personal injury, disability, death, illness, claim, cost, damages, expenses, fees, or liability of any kind, that my child(ren) or I may experience or incur in connection with my child(ren) ‘s attendance at the Volleyball1on1 Summer Camp or participation in Volleyball1on1 programming, including exposure to or infection from COVID-19 and any of its variants (“Claims”).
5. In any emergency requiring medical attention, I hereby authorize the staff of the Volleyball1on1 / St. Johns Volleyball Class to act for my child(ren) according to their best judgment. I hereby waive and release all Claims against Volleyball1on1, its officers, members, managers, owners, coaches, employees, sponsors, volunteers, and other agents arising from their actions in such situation and hereby agree to pay for all associated costs for medical attention for my child(ren), present and future, through my health insurance coverage and / or personal finances.
6. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS Volleyball1on1 / St. Johns Volleyball, their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (RELEASES), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASES OR OTHERWISE, to the fullest extent permitted by law.
7. By signing this Consent and Release Form, I confirm that I have fully informed myself of the contents of this Volleyball1on1 / St Johns Volleyball Club Medical Information & Parental Consent and Waiver by reading it before I signed it.
I warrant that I possess all the rights, powers, and privileges of a parent or legal guardian necessary to execute this document with binding legal effects.
– Please list both parents information so that we can easily reach you in case of an emergency.