Grade
*
Select Option
Age 0-3 Nursery
Age 4-5/Pre-school
Kindergarten
First
Second
Third
Fourth
Fifth
LIABILITY RELEASE: In consideration of Ark and Dove allowing the above child(ren) to participate in LOGOS activities, I, the undersigned, do hereby release, forever discharge, and agree to hold harmless Ark and Dove, its directors, employees, volunteers, and agents (collectively herein the “Church”) from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the above child(ren) while involved in LOGOS. Furthermore, on behalf of my minor child(ren), I hereby assume all risk of accidental personal injury, sickness, death, damage, and expense as a result of participation in activities involved therein.
*
Please select all that apply.
YES
Option
COVID WAIVER: For LOGOS participation during the COVID-19 virus epidemic, I also voluntarily accept, acknowledge my agreement, and will follow, as parent or guardian on behalf of myself and my child, the following conditions or requirements: 1. Based on the COVID-19 virus, I verify that neither myself nor my child is showing any symptoms of COVID-19, including cough, shortness of breath or difficulty breathing, or at least two of the following: fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, new loss of taste or smell. I accept, agree and acknowledge that if my child develops these or other related symptoms during the program, or I or my child or anyone in the child’s household tests positive for COVID-19, my child may not be able to further participate and that the AAC Health Department will be consulted.
*
Please select all that apply.
YES
3. I accept, acknowledge and understand that Ark and Dove and Ark and Dove staff will, to the best of their ability, require and enforce all applicable requirements which may assist in offering protection from the COVID-19 epidemic, as specified in the Center for Disease Control guidelines, including but not limited to social distancing, sharing of supplies, crafts and equipment, and cleaning and hand washing, but understand the atmosphere of the program may not allow perfect enforcement and assume the risk participation and waive and release the Church, its agents, servants, and employees, from all claims and liabilities of any kind related to that participation or any requirement imposed as the Ark and Dove staff makes their best efforts to comply with the guidelines.
*
Please select all that apply.
YES