STUDENT’S FULL NAME:_____________________________________GRADE: _______
Informed MCSD Consent Agreement for 2020-2021
Dear Parents/Guardians and Students,
Marshalltown Community School District (MCSD) will resume athletics/activities for the 2020-2021 school year. MCSD will take reasonable measures to prevent the spread of COVID19, including tracking and following applicable state and federal guidance. Local guidance will also be provided by state organizations including (but not limited to) the Iowa High School Athletic Association (IAHSAA), Iowa Girls High School Athletic Union (IGHSAU), Iowa High School Music Association (IHSMA) and the Iowa High School Speech Association (IHSSA). However, the possibility of transmission cannot be eliminated. Families must recognize and acknowledge the risks before participating in athletics/activities. By initialing and signing this Informed Consent Agreement, you acknowledge, accept, and agree to the statements listed below.
PRINT STUDENT’S FULL NAME ____________________________________________________ is allowed to attend/participate in-person activities including (but not limited to) MCSD educational, co-curricular, sports, activities and extracurricular programs. The undersigned (parent/guardian and student) acknowledges and agrees to the following:
_______ _______ Participation in athletics/activities is purely voluntary.
_______ _______ My child has permission to participate in meetings, practice, competitions or other team activities as directed by the coaching staff and/or sponsor.
_______ _______ Neither my child or I will attend meetings, practice, competitions or other activities if any member of our household is exhibiting A) exhibiting symptoms of illness, such as cough, fever, or shortness of breath; B) has been diagnosed or has a suspected diagnosis of COVID-19; and/or C) has spent time with another individual who has been diagnosed and/or has a suspected diagnosis of COVID-19.
_______ _______ I agree to immediately inform my coach/sponsor and the Activities Director if myself or any member of our household has been diagnosed and/ or has a suspected diagnosis of COVID-19.
_______ _______ I am aware that my child and I may be exposed to COVID-19 while participating or attending meetings, practices, competitions and/or other team functions. I understand that this exposure carries a risk of infection, serious injury, or death.
_______ ________ My child is voluntarily participating in MCSD athletics/activities and I agree to assume any and all risks of infection, injury, or death, whether those risks are known or unknown.
Parents/Guardians AND Students Must Initial and Sign.
_________ _________ I agree to abide by all safety measures or processes put in place by the school district, coaching staff or activity sponsor (including but not limited) to wearing masks in confined spaces, appropriate social distancing, and sanitation of shared/used equipment.
_________ _________ I will do my part to reduce the spread of COVID-19. This includes (but is not limited to) the daily practice of overall health and wellness such as proper hygiene, washing personal clothes daily, frequently washing of hands/using hand sanitizer. I will also do my best to get adequate sleep and practice proper nutrition and hydration.
_________ _________ I forever release the Marshalltown Community School District from any liabilities, causes of action, lawsuits, claims, demands, or damages of any kind whatsoever that I, my assignees, heirs, guardians, next of kin, spouse, and legal representatives have, or may have in the future, related to participation in athletics/activities.
I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND THE CONTENTS. I AM AWARE OF THE RISKS OF PARTICIPATING IN ATHLETICS/ACTIVITIES DURING THE COVID-19 PANDEMIC. I AM AWARE THAT THIS FORM CONTAINS A RELEASE OF LIABILITY.
Signature of Participant Date
Signature of Parent/Guardian Date