Next Level Field Hockey, 2021 Covid Sign-off

This form is a one-time acknowledgement with the risks associated with your athlete's participation in our Sunday training sessions at Red Rose Arena.

Email address *

Athlete's Last Name *

Athlete's First Name *

Please acknowledge the following: *

The undersigned acknowledge that participating in athletic programs, events, and activities may include a possible exposure to a communicable disease including but not limited to MRSA, influenza, and COVID-19. The undersigned further acknowledge that they are aware of the risks associated with COVID-19 and that certain vulnerable individuals may have greater health risks associated with exposure to COVID-19, including individuals with serious underlying health conditions such as, but not limited to: high blood pressure, chronic lung disease, diabetes, asthma, and those whose immune systems that are compromised by chemotherapy for cancer, and other conditions requiring such therapy. While particular recommendations and personal discipline may reduce the risks associated with participating in athletics during the COVID-19 pandemic, the risk of serious illness, medical complications and possible death does exist.

We knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of others, and assume full responsibility for Athlete’s participation in athletics during the COVID-19 pandemic. We willingly agree to comply with the stated recommendations put forth by Next Level Field Hockey, LLC to limit the exposure and spread of COVID-19 and other communicable diseases. We certify that Athlete is in good physical condition or believe Athlete to be in good physical condition and allow participation in this sport at our own risk.

I give my consent for my athlete's temperature to be recorded prior to training.

Required

Full name of person completing this waiver. *

Your relationship to the Athlete. *

A copy of your responses will be emailed to the address you provided.

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