Parent/Guardian Authorization Agreement:
Due to COVID-19, participants must agree to all of the following*:
- Screen for symptoms and check their temperature the morning of the program to assess for the following:
- experiencing a fever, new cough, new loss of taste or smell, sore throat, congestion, or shortness of breath
- Stay home if experiencing high temperatures (100.4 or above) or symptoms that cannot be explained by another condition other than COVID-19 and have not tested negative within 24 hours of participating in the program.
- Stay home if participant is a COVID-19 positive individual still within the first five (5) days of the initial positive test result and in isolation under CA Department of Public Health guidance and continue isolation if participant has not tested negative with symptoms improving after the first five (5) days.
- Wear a mask if the participant was recently COVID-19 positive, was cleared out of isolation after testing negative on Day 5 from their initial positive test result, their symptoms are improving, but still within 10 days from their initial positive test result.
- If participant has had a Close Contact exposure to a COVID-19 positive individual in the last 10 days, wear a mask if they have not yet tested negative or have tested negative but still have COVID-like symptoms.
* These guidelines are from the California Department of Public Health (CDPH) for the general public.
I acknowledge and agree that the East Bay Regional Park District is directing all individuals that participate in East Bay Regional Park District activities to conduct activities in compliance with applicable Federal, State, County and local health orders. Further, any participant recognizes that it is their own responsibility to ensure compliance with all applicable orders. Further, I acknowledge and understand that the East Bay Regional Park District does not and cannot guarantee that any participants will not become infected with COVID-19 or any illness or injury while participating in the planned activities. I hereby release, covenant not to sue, discharge, and hold harmless the East Bay Regional Park District, its Board of Directors, officers, employees, agents, defend and representatives from any claims, including all liabilities, actions, damages, costs or expenses of any kind, arising out of or relating to the planned activities including but not limited to any illness, death, and loss of any kind related to COVID-19 or any illness or injury. I understand and agree to this release includes any claims based on the actions, omissions, or negligence of East Bay Regional Park District, its Board of Directors, officers, employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any activity.
WAIVER, RELEASE AND ASSUMPTION OF RISK AGREEMENT
and
AUTHORIZATION FOR EMERGENCY TREATMENT OR TRANSPORTATION
I, the undersigned, as participant, or as parent or legal guardian of the child listed on this form, hereby agree to hold harmless, release and forever discharge The East Bay Regional Park District, its officers, directors, agents and employees (collectively “District”) and their representatives, from any and all claims and demands whatsoever which the undersigned, and any of them or any third party and their representatives or any person acting under their behalf have, or may have, against the District by reason of any accident, illness, injury, or death to any person or persons, or damage to, loss of, or destruction of property arising or resulting directly or indirectly from my or my child’s participation in the District’s program, and occurring during said participation, or anytime subsequent thereto regardless of whether said claims or demands arise out of negligence on the part of the District. The terms of this release shall serve as a release and assumption of risk for myself, my child, heirs, executives, administrators, and for all of my family members.
I understand, agree, and acknowledge that some activities in this program or activity may be of a hazardous nature and/or include physical and/or strenuous activity. I hereby assume all risk of such activities and also assume all risk of such activities on behalf of my child. Understanding this, I state to the best of my knowledge that I or my child listed on this form have no medical, physical, mental, or emotional health conditions which would hinder my or my child's active participation in the program listed on this form.
In the case of an emergency in which I am not able to give permission for medical treatment and my designated emergency contact cannot be reached, I authorize the staff or agents of the District to obtain whatever medical treatment is deemed necessary for my or my child's welfare. In the case of my child, this authorization is given pursuant to the provisions of Section 25.8 of the Civil Code of California. I further understand and agree that I will be financially responsible for all charges and fees incurred in the rendering of said emergency treatment, regardless of whether my medical insurance would cover such charges and fees.
I give my full permission to East Bay Regional Park District and any other media sources to use my or my child’s name and any photographs, videos, or recordings for any publicity and promotional purposes without obligation or liability to me.