Due to the outbreak of the novel Coronavirus, COVID-19, we are taking extra precautions with the intake of each client, health history review, as well as sanitization and disinfecting practices. Please complete the following and sign below. A detailed description of safer facility practices can be found a on our website as well as on the parent portal home screen.
Symptoms of COVID-19 include:
• Dry cough
• Difficulty breathing
Miller Swim School has put in place preventative measures to reduce the spread of COVID-19; however, MSS cannot guarantee that you or your child(ren) will not become infected with COVID-19. As with every other activity, there could be an increase in your risk and in your child(ren)'s risk of contracting COVID-19.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending MSS and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at MSS may result from the actions, omissions, or negligence of myself and others, including, but not limited to, MSS employees, volunteers, and program participants and their families.
I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)'s attendance at MSS or participation in MSS programming ("Claims"). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless MSS, its employees, agents, 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 MSS, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in MSS program.
I the undersigned, agree to the following:
• I understand the above symptoms and affirm that I, as well as all household members, do not currently have, nor have experienced the symptoms listed above within the last 14 days.
• For the safety of our staff and swimmers, any person with a temperature above 100.4 are to be sent home until they have no fever and no evidence of COVID-19 symptoms for 72 hours.
• I affirm that I, as well as all household members, have not been diagnosed with COVID-19 within the last 30 days.
• I affirm that I, as well as all household members have not been knowingly exposed to anyone diagnosed with COVID-19 in the last 14 days.
• I affirm that I, as well as all household members, have not traveled outside of the country or to any city other than our own that is or has been considered a "hot spot" for COVID-19 infections within the last 30 days
• I understand that this business cannot be held liable for any exposure to the virus or any other contagion caused by misinformation on this form or the health history provided by each client.
By signing below, I agree to each above statement and release Miller Swim School and its staff, owners, officers, and personnel, from any and all liability for the unintentional exposure or harm due to COVID-19. I also confirm that all information regarding my health and health history is represented as accurate and truthful. Finally, if any of the aforementioned changes throughout the course of my attendance at MSS, I will be held liable for notifying MSS staff of these changes and I am responsible for continuing adhere to the COVID-19 safety policy, even if this means a forfeiture of my or my swimmers lessons.
I understand that participation is entirely by my own choice and with the understanding that there is risk and the possibility of accidental injury in any activity involving unusual motion or height. I've read the above and agree.
Having been informed of the activities to be conducted by Miller Swim School I, a parent or guardian of the participant, give my approval for the above named student's participation in any and all activities of the program. In consideration of my or the student's membership acceptance in Miller Swim School, I hereby forever waive, and forever release and discharge Miller Swim School, their officers, owners, directors, professional consultants, and employees, from all liability for any and all damages and injuries suffered by the participant in connection with said use of the aforementioned equipment, instructors, and facilities. I've read the above and agree.