COVID-19 Policy and Waiver

LOLFamilies, Inc Covid Policies and Agreement
Member Agreements Regarding COVID-19 & CDC Compliance
If you would like a copy of our Policies & Procedures outlining the preventative measures
we are taking against the spread of SARS-CoV-2, please let us know.
Please initial each line below:
1. ________ I agree to not come to any in person classes at Eagle Lake Park or Boys and Girls Club if I am
experiencing any of the symptoms of Covid-19, including fever, cough, shortness of breath, chest tightness,
difficulty breathing, or new loss of sense of smell, or have been caring for someone with these symptoms.
2.________ I agree to wear a face covering or mask when in classes that are in a pavilion. If the class is in the
field or I am walking through the park, it is each individual family’s choice if they want to wear a mask or
face covering. If I do not have a mask or face covering for a class in a pavilion I/my child will not be allowed
to attend class.
3. ________ I agree to sanitize my hands before entering into any class in a Pavilion as well as any time I use
the rest rooms.
4. ________ I agree to inform LOL Families, Inc immediately if I come down with the symptoms of COVID-19
and/or I test positive for the virus.
5. ________ I agree to inform LOL Families, Inc if I have been in contact with anyone who has tested positive for
COVID-19.
6. ________ I understand that if any teacher develops the symptoms of Covid-19, they will contact every
student as well as LOL Families, Inc to inform them of potential exposure. If they test positive for Covid-19, they

will not teach in person again until the 10th day after symptoms begin or if asymptomatic, 10 days after a positive test.
7. ________ I understand that even with protective measures, there is no guarantee that I will not be exposed
to the Covid-19 virus at any LOL Families, Inc classes or functions in person.
Please sign to acknowledge you understand and agree to all statements above.

Print Name: Signature (Patient or Guardian): Date:

 

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LOLFamilies, Inc Covid Policies and Agreement
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 large groups of people.
LOL Families, Inc have put in place preventative measures to reduce the spread of COVID-19; however, LOL
Families, Inc cannot guarantee that you will not become infected with COVID-19 or that you are not already an
asymptomatic carrier of COVID-19. Further, participating in in-person classes or activities. with LOL Families,
Inc could increase your risk of contracting COVID-19.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk
that I may be exposed to or infected by COVID-19 by participating in in-person classes with LOL Families, Inc
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 by participating in in-person classes
or activities with LOL Families, Inc may result from the actions, omissions, or negligence of myself and others,
including, but not limited to, LOL Families, Inc administrators, owners and independently contracted teachers.
In consideration for being permitted to participate in in-person classes or activities with LOL Families, Inc, I
voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself
(including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or
expense, of any kind, that I may experience or incur in connection with participating in in-person classes with
LOL Families, Inc. On my behalf, and on behalf of my heirs, executors, administrators, personal
representatives, and assigns, I hereby release, covenant not to sue, discharge, and hold harmless LOL Families,
Inc administrators, owners and independently contracted teachers, of and from any 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 LOL Families,
Inc administrators, owners and independently contracted teachers whether a COVID-19 infection occurs before,
during, or after participating in in-person classes or activities with LOL Families
Print Name: Signature (Patient or Guardian): Date:

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