MHS Programming Covid-19 Waiver and Release for Minnetonka School District
Consistent with Executive Order 20-56, Minnetonka Public Schools will begin allowing limited access to its indoor and outdoor facilities.
All users, groups, and individuals must adhere to the Minnesota Department of Health Guidelines for youth sports. Guidelines for interactions, skill work, and sizes of the pods (25 or less) per field/facility are outlined in this document:
However, even with caution and preventative measures, an inherent risk of exposure to COVID-19 exists in any public setting where people from different households are present. COVID-19 is an extremely contagious disease that can be transmitted even by people who are asymptomatic and can lead to serious illness and death. By accessing the District’s fields and indoor facilities, you and your child voluntarily assume all risks related to exposure of COVID-19.
**By signing (or electronic submission via email) below, I acknowledge that I understand the inherent risks associated with exposure to COVID-19 and am voluntarily assuming such risks in order for me and/or my child to utilize the District’s facilities. I hereby release and waive, and further agree to indemnify, hold harmless, or reimburse the School District and its individual board members, agents, employees, and representatives, from and against any claim which I, my child, or any other party, may have or claim to have, for any losses, damages, or injuries arising out of or relating to exposure to COVID-19 in connection with my or my child’s access to district facilities.**
**Participant or parent/guardian or coach certifies that they will comply with any applicable Executive Order from the Governor of Minnesota regarding field use or indoor facilities**
**Participant and parent/guardian understands that if participant displays any of the symptoms of Covid-19 they are NOT to attend activities on ISD 276 facilities and must quarantine for 14 days. For symptoms:
If you do not complete this form you are not permitted to use ISD 276 facilities for summer 2020.
We/I agree to all of the above information. (If you cannot answer 'Yes' you are unable to use district facilities or participate in programming using district facilities)
WE/I understand the signs and symptoms of Covid-19 and will NOT attend ISD 276 facilities if any of them are present in the participant. This includes daily temperature monitoring as the participants responsibility. Symptoms can be found:
(If you cannot answer 'Yes' you are unable to use district facilities or participate in programming using district facilities)
Parents First Name
Parents Last Name
Student/participant First Name
Student/participant Last Name
Student/participant grade for 20-21 school year
None of the above
Organization or Group (associated with HS programming/summer camps/mshsl summer waiver) ***If you are involved in more than one of these groups you need to submit the form one time for each group you will participate in.
Boys Basketball Camp k-8
Boys Basketball Camp/Workouts 9-12
Boys CC 9-12
Boys CC k-8
Boys Hockey k-8
Boys Hockey 9-12
Boys Lacrosse k-8
Boys Lacrosse 9-12
Boys Soccer 9-12
Boys soccer k-8
Cheerleading High School (9-12)
Cheerleading Camp (k-8)
Coach (I am working the camp or a current coach)
ESY Summer Training (Moon)
Girls Basketball Camp k-8
Girls Basketball Camp/Workouts 9-12
Girls CC 9-12
Girls CC k-8
Girls Golf Summer
Girls Hockey k -8
Girls Hockey 9-12
Girls Lacrosse k-8
Girls Lacrosse 9-12
Girls soccer k-8
Girls Soccer 9-12
Marching Band 9-12
MDT (Dance) Summer Trainings
Nordic Ski 9-12
Performance Dance Team
Summer Strength Training 9-12
Theater Camp k-8
Theater Camp 9-12
Visitor to MHS Campus
Volleyball Camps k-8
Volleyball Camp/workouts 9-12
None of the above
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