Oley Valley Participation Waiver for Communicable Diseases including COVID-19 (For OVSD Staff Members)
Note - all students who plan on participating in summer workouts, a Fall/Winter/Spring sport, or any extracurricular activity must submit an online waiver which must be completed in full. If there are any concerns with this, please contact the Athletic Office. The full Extracurricular & Athletic Healthy and Safety Plan can be found on the OVSD Athletic Website at
. ANY STUDENT OR STAFF MEMBER WHO HAS COVID-19 SYMPTOMS, OR HAS BEEN RECENTLY EXPOSED TO SOMEONE WHO HAS COVID-19, IS NOT PERMITTED TO PARTICIPATE IN ANY SUMMER TRAININGS OR ACTIVITIES AND MUST STAY HOME! These symptoms include but are not limited to: temperature over 100.4, cough, nausea or diarrhea, sore throat, shortness of breath, or close contact/cared for someone with COVID-19
The COVID-19 pandemic has presented athletics and extracurricular activities across the world with a myriad of challenges. The COVID-19 virus is a highly contagious illness that primarily attacks the upper respiratory system. The virus that causes COVID-19 can infect people of all ages. Research from the Centers for Disease Control, among others, has found that while children do get infected by COVID-19, relatively few children with COVID-19 are hospitalized. However, some severe outcomes have been reported in children, and a child with a mild or even asymptomatic case of COVID-19 can spread the infection to others who may be far more vulnerable. While it is not possible to eliminate all risk of furthering the spread of COVID-19, the current science suggests there are many steps schools can take to reduce the risks to students, coaches, advisors, and their families.
The OVSD will take the necessary precautions and recommendations from the federal, state, and local governments, CDC, PA DOH, as well as the NFHS and PIAA. The OVSD realizes the knowledge regarding COVID-19 is constantly changing as new information and treatments become available. These recommendations will be adjusted as needed as new information becomes available in order to decrease the risk of exposure for our staff, students, and spectators.
These Recommendations include but may not be limited to:
1. In the GREEN phase, Athletes, Students, Coaches, Advisors, and Staff shall self-assess for COVID-19 symptoms at home before arriving at any school sponsored activity or event. In the YELLOW phase, Athletes, Coaches, and Staff may undergo a COVID-19 health screening prior to any practice, event, or team meeting. The type of screening will be dependent upon the available resources and the Phase level. The purpose is to check for signs and symptoms of COVID-19. It may include a questionnaire and temperature check as needed.
2. Promote healthy hygiene practices such as hand washing, using hand sanitizer, cough in your elbow, avoid touching eyes, nose, face and mouth, no spitting, no gum chewing, No Handshakes/Celebrations (high fives, fist/elbow bumps, chest bumps, hugging)
3. Intensify cleaning, disinfection, and ventilation in facilities and of equipment
4. Encourage social distancing through increased spacing, small groups, and limited mixing between groups, if feasible
5. Educate Athletes, Students, Coaches, Advisors, and Staff on health and safety protocols
6. Anyone who is sick must stay home
7. If a student or employee gets sick, they will be sent home
8. Regularly communicate and monitor developments with local authorities, employees, and families regarding cases, exposures, and updates to policies and procedures
9. Athletes, Students, Coaches, Advisors, and Staff MUST provide their own water bottle for hydration. Water bottles must not be shared
10. PPE (gloves, masks, eye protection) will be used as needed and situations warrant, or determined by local/state governments. Face Coverings will not be used for athletes while practicing or competing.
I understand that participating in athletic programs, extracurricular events, and activities may include a possible exposure to a communicable disease including but not limited to MRSA, influenza, and COVID-19. While particular recommendations and personal discipline may reduce the risk, the risk of serious illness and death does exist. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of others, and assume full responsibility for my participation. I willingly agree to comply with the stated recommendations put forth by the OVSD to limit the exposure and spread of COVID-19 and other communicable diseases.
Staff Member First Name
Staff Member Last Name
Sport/s or Activity/s
Boys Cross Country
Girls Cross Country
Girls Volleyball (coop)
Boys Track & Field
Girls Track & Field
Boys Volleyball (coop)
Boys Lacrosse (coop)
Girls Lacrosse (coop)
Marching Band/Band Front/Jazz Band
Other Extracurricular Activity
For OVSD Staff Members - By signing below (type full name), I am acknowledging that I have read and agree to the parameters of the OVSD Extracurricular & Athletic Health and Safety Plan. I will not show up or participate in any summer workout, sporting event, or extracurricular activity if I have any symptoms of COVID-19 or have had close contact with someone who has COVID-19. I have been trained on the warning signs and safety protocols and will in turn will train and educate the students under my supervision. I will report any COVID-19 concerns to the Director of Athletics and the Athletic Trainers (as applicable in-season). I will also follow all applicable and current CDC and Pennsylvania Department of Health guidelines and requirements.
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of Oley Valley School District.