TUSTIN UNIFIED SCHOOL DISTRICT
INFORMED CONSENT AND WAIVER FOR PARTICIPANTS IN
MODERATE-CONTACT AND HIGH-CONTACT YOUTH SPORTS
Sport (may list multiple Sports): ___________________________________________________________
Athlete Full Name: _____________________________________________________________________
Athlete Grade Level (2020-21 School Year): 7; 8; 9; 10; 11; 12
Athlete is: a minor (under age 18); an adult (age 18 or older)
Introduction and Purpose: There presently exists a public health emergency arising from the spread of the coronavirus and its variants that cause COVID-19 (“Coronavirus”). However, on February 19, 2021, the California Department of Public Health issued guidance (“CDPH Guidance”) that, if followed, will permit the Tustin Unified School District (“District”) to allow the resumption of certain moderate-contact and high-contact outdoor youth sports.
Student participation in the sport(s) identified above (“Sport”) is not mandatory. Each student who desires to participate in the Sport (“Athlete”) and his, her, or their parent or legal guardian (“Parent”) must decide for themselves if the benefits of the Athlete participating in the Sport outweigh the risks associated with participation in the Sport, including, among others, the risks associated with potential or actual exposure to, and infection by, the Coronavirus. However, in accordance with the CDPH Guidance, it is mandatory that the District obtain this “Informed Consent and Waiver for Participants in Moderate-Contact and High Contact Youth Sports” (“Informed Consent”) from each Athlete and his, her, or their Parent. Otherwise, the District cannot allow the Athlete to participate in the Sport.
Risks of Coronavirus Exposure and Infection: Below is information regarding the risks associated with potential and actual exposure to, and infection by, the Coronavirus. The District believes that such information is generally accurate as of the date of this form shown below. However, because the Coronavirus mutates, and because the scientific understanding of the Coronavirus and related matters has been evolving since the beginning of the pandemic, relevant information may change without notice. With that in mind, the Athlete and his, her, or their Parent should consider all of the following in deciding whether to sign this Informed Consent:
(i) The District highly recommends that each Athlete and his, her, or their Parent keep themselves apprised of available information regarding the Coronavirus and youth sports occurring during the pandemic. Although the following list is not exhaustive, relevant information presently is available at the following links:
(1) CDPH Guidance — https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/outdoor-indoor-recreational-sports.aspx;
(2) Considerations for Youth Sports Administrators — https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/youth-sports.html;
(3) Toolkit for Youth Sports — https://www.cdc.gov/coronavirus/2019-ncov/communication/toolkits/youth-sports.html;
(4) COVID-19 Interim Guidance: Return to Schools — https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/covid-19-interim-guidance-return-to-sports/; and
(5) Education Based Athletics COVID-19 Modifications — https://cifstate.org/covid-19/CIF_CV-19_Guidelines.pdf.
(ii) COVID-19 is a respiratory disease that spreads from person to person primarily through respiratory droplets produced when an infected person coughs, sneezes, or talks. Some people who are infected with the Coronavirus may not exhibit any obvious symptoms. However, people of all ages are at risk of experiencing significant consequences as a result of being infected by, or infecting someone else with, the Coronavirus, including, among possible others, difficulty recovering from the initial infection, health impacts that continue long after the initial infection has resolved, loss of mental or sensory capability, permanent disability, death, loss or impairment of social functionality or relationships, and economic losses.
(iii) The nature of sports and/or the manner in which sports are played or conducted can increase the risk that the Coronavirus will spread. Athletes participating in youth sports will have more frequent and/or sustained close (and even face-to-face) contact with other Athletes, and Athletes may share equipment, or have contact with the same equipment as other Athletes. Physical exertion increases breathing rates and the amount of air that is inhaled and exhaled, thereby increasing the risk.
(iv) Competitions can increase the risks of exposure to and infection by the Coronavirus (whether the competition is between teams at the same school, teams from different schools in the District, or teams from different communities, school districts, regions, or states) by bringing together larger groups of individuals (e.g., other athletes, coaches, families, friends, alumni, and other spectators).
(v) The Coronavirus infection rates within our communities, regions, and state can influence the infection rates among Athletes and their coaches, families, friends, alumni, and other spectators. Although vaccines against the Coronavirus have been developed, the individuals who have been fully vaccinated to date are a relatively small percentage of the overall population. Although vaccines are known to reduce the chances of severe consequences and hospitalization, vaccines do not prevent 100% of infections and it presently is uncertain how well vaccines will prevent reinfection or prevent the spread of the Coronavirus by a vaccinated person.
(vi) While the District will make efforts to reduce the potential for Athletes and others to be exposed to or infected by the Coronavirus, nothing that the District can do (while still allowing youth sports to occur) will completely eliminate the risk of exposure to or infection by the Coronavirus.
Required Precautions: By signing this Informed Consent, each of the Athlete and Parent hereby agree that:
(i) Neither the Athlete, nor any Parent or family member, shall attend any conditioning, practice, game or competition, if he, she, or they has been diagnosed with, or has knowledge that he, she, or they are infected with, the Coronavirus or, within the preceding 10 days, has suffered or exhibited symptoms typically associated with infection by the Coronavirus.
(ii) The Athlete must wear a well-fitting face covering (over mouth and nose) at all times practicable, including, without limitation, while being transported to/from events, while at or in locker rooms, restrooms and other facilities, between practice drills, and otherwise whenever not actively conditioning, practicing, playing, or competing. To the extent tolerable, the Athlete should wear face coverings while actively conditioning, practicing, playing, or competing.
(iii) The Athlete must practice good hygiene, including, as applicable, (1) properly washing his, her, or their hands before, during breaks in, and after the conclusion of the activity, (2) covering up and/or redirecting coughs or sneezes away from others, and (3) wiping down equipment after use
(iv) The Athlete and each Parent and family member present at an event shall cooperate with screening procedures and requirements intended to prevent the spread of the Coronavirus. Screening procedures may include, without limitation, temperature checks, questions regarding symptoms and possible exposure, and, possibly, testing for infection. Requirements may include, without limitation, physical distancing and wearing of well-fitting facial coverings (over mouth and nose).
(v) Any coach or other District representative may request that an Athlete, Parent, or family member who does not fully comply with the foregoing required precautions leave the location of a Sport-related activity, and each such person shall immediately and peaceably leave that location.
Transportation: Due to a large increase in students participating in youth sports and required physical distancing on school buses, the District presently is unable to transport Athletes to competitions and other events. If the Athlete is a minor, a Parent must transport the Athlete to all events. Because of significant liability concerns, the Parent agrees that he, she, or they will not allow the Athlete to drive himself, herself or themself, or any others, to and/or from any competition or other event. Due to the potential impact on others that interact with Athletes, including teams, family members, and teachers and other District staff, the District strongly recommends that travel in personal vehicles should be limited to only members of the same household. Should a Parent, despite such risks, transport Athletes and others from outside a household group in the same vehicle, the District further encourages the Parent to comply to the extent possible with safety protocols, such as distancing and wearing of facial coverings.
THIS INFORMED CONSENT ADDRESSES SIGNIFICANT ISSUES — DO NOT SIGN THIS INFORMED CONSENT IF YOU DO NOT FULLY UNDERSTAND IT OR DO NOT ACCEPT ITS TERMS AND CONDITIONS.
Each of the undersigned acknowledges and agrees that he, she, or they: (i) has been fully informed of , understands, and has carefully considered the risks associated with the exposure to and infection by the Coronavirus in connection with participation in the Sport; (ii) accepts and assumes any and all such risks; (iii) accepts the terms and conditions of this Informed Consent; and (iv) on that basis, consents to participation in the Sport by the Athlete.
ATHLETE SIGNATURE__________________________ _______________________________ ____________________
Print Name Signature Date Signed
PARENT SIGNATURE__________________________ ________________________________ ____________________
Print Name Signature Date Signed
Note: If the Athlete is a minor, then, unless the Athlete has been emancipated and has the power to contract and make life decisions, and has provided verifiable conformation of such emancipated status to the District, both the Athlete and the Parent must sign this Informed Consent.