Untitled Header Image Untitled Header Image Untitled Header Image
 

2022 Graduation Participation Waiver

indicates a required answer

Please fill-in these fields, READ the below Participation Waiver for all CHESS Events (Academic Co-ops, Enrichment Day Co-ops and/or other CHESS sponsored activities) for the 2021-22 school year.  Submitting this form confirms you have read and agree to the below waiver.

1. *

Last Name:

2. *

First Name:

3. *

Date:

4. *

Email address:

 


   
          I acknowledge that there are certain risks and hazards of illness, personal injury, or loss of property that could arise through participation in any group activities or gatherings. I hereby assume all risks associated with our family’s participation in CHESS Co-op. I also give permission for my child(ren) to receive medical and/or emergency treatment and/or transport. (Non-emergency medical treatment or elective surgery is not included in this authorization.)   

          I voluntarily seek the resources provided by CHESS and acknowledge that I may be increasing my family’s risk of exposure to COVID-19 by choosing to participate. 


Coronavirus 

  • I understand that the common symptoms of COVID-19 include, but are not limited to, fever, fatigue, dry cough, congestion, chills, body aches, sore throat, loss of taste and smell, and difficulty breathing. I affirm that if I, or any of our immediate family/household members, have experienced any of the symptoms listed within the last 10 days, or have been diagnosed with COVID-19 within the past 10 days, we will NOT attend CHESS activities. 
     

  • Instead we will a) wait 10 days from the first onset of symptoms or any direct exposure to someone who has tested positive, to be sure that none of us is experiencing any COVID symptoms, OR b) wait at least 5 days, be sure we are not experiencing any symptoms, and get a COVID test for each family member in question-- with negative test results… before returning to CHESS activities.|
     

  • I affirm that I will immediately notify CHESS if anyone in my family/household tests positive (or is presumptively positive) for COVID-19 after having recently attended a CHESS event where other attendees could have been exposed.
     

  • Vaccines: I acknowledge that it is my/our sole responsibility as parents to investigate and weigh the risks associated with participation in CHESS Co-ops, and to determine if, based on those risks, it makes sense for our family to participate. I also understand that it is my/our responsibility as parents to evaluate vaccines and other preventative/mitigating steps and determine if those steps are right for me and/or my child. Finally, I understand and acknowledge that CHESS respects each parent’s decision in this regard, and out of respect for each family and participant, will NOT require vaccination to participate, nor inquire into the vaccination status of CHESS students or their family members.
     

  • Masks: I understand and acknowledge that unless the facilities in which we are gathering require the wearing of masks, it is the personal decision and sole responsibility of parents to decide if they and their children will wear masks. CHESS does not require attendees to wear masks, although we respect the decisions of anyone who chooses to do so voluntarily.
     

  • I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren), family, and I may be exposed to or infected by COVID-19 by participating in CHESS activities and that such exposure or infection may result in personal injury, illness, permanent disability, or death. I further acknowledge that CHESS cannot guarantee that I will not become infected with COVID-19, and that exposure to and/or infection may result from the actions or omissions of myself and others, including, but not limited to leaders, coordinators, volunteers, attendees, and their families.

Consent by parent (or legal guardian):

          I understand that Christian Home Educators’ Support System is a volunteer organization and I hereby waive, release, and hold harmless, CHESS, its agents, officers, leaders, and representatives, along with the those from the facility in which we meet, West Lansing Church of Christ, from all liability in the event of illness, injury, or aggravated physical conditions sustained during, or as a result of, participation in this homeschool co-op program.

          I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren), family, or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that we may experience or incur in connection with my child(ren)’s attendance at CHESS co-ops or other CHESS events (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless CHESS and West Lansing Church of Christ, its employees, agents, volunteers, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of CHESS and West Lansing Church of Christ, its employees, agents, volunteers, and representatives, whether a COVID-19 infection might occur before, during, or after participation.  

          By clicking SUBMIT below, I agree to these terms, and I do so freely and voluntarily, without inducement, on behalf of myself and all participating members of our family. I certify that I have read the information provided, that I understand the risks involved, and agree to comply with requested protocol and procedures to the best of my ability.