I certify that I am the parent or guardian of a child (“participant”) enrolled at Charlottesville Day School (“CDS”).

On behalf of myself and participant, we agree to abide by all rules promulgated by CDS while participating in any CDS program including, without limitation, any and all instructions and rules regarding social distancing, hygiene, the wearing of masks, and anything else required, at the discretion of CDS, to help reduce the likelihood of the spread of COVID-19.

On behalf of myself and participant, I agree that an inherent risk of exposure to COVID-19 exists in any public place where people are present. I acknowledge that CDS cannot and does not guarantee that participant or family will not contract or become infected with COVID-19 or related disease.

By visiting CDS and/or participating in CDS programs of any kind, I on behalf of the participant, voluntarily assume all risks related to exposure to COVID-19.

I AND PARTICIPANT HEREBY RELEASE, WAIVE, AND AGREE TO HOLD HARMLESS CDS AND ITS TRUSTEES, OFFICERS, EMPLOYEES, VOLUNTEERS, FROM AND AGAINST ANY ECONOMIC OR NON- ECONOMIC LOSSES, DAMAGES, SUITS, CLAIMS, ATTORNEY’S FEES, COSTS, OR DEMANDS, OF EVERY KIND AND NATURE WHATSOEVER, WHETHER FOR BODILY INJURY, PROPERTY DAMAGE, DEATH, OR LOSS OTHERWISE, WHETHER CAUSED IN WHOLE OR IN PART BY CDS’S NEGLIGENCE ARISING FROM, OR ALLEGED TO HAVE ARISEN FROM PARTICIPANTS PRESENCE ON CDS PROPERTY OR PARTICIPATION IN ANY CDS PROGRAMS.

1. I agree to follow the CDS COVID-19 Protocols as outlined in the CDS COVID-19 Handbook if there is a suspicion my child or family member has symptoms of or has been exposed to COVID-19.

2. I agree that I will not send my child to school with a fever of 100.0F (updated 10/9/20) or higher.

3. I agree to keep my child home for 24 hours after a resolution of a fever of 100.0F (updated 10/9/20).

4. I understand that I may be asked to provide a doctor’s note to document my child’s ability to return to school and document illness.

5. I agree that I will review the COVID-19 symptom list and report any symptoms to CDS.

6. I agree that if my child is in contact with a known or suspected case of COVID-19, I will not send my child to school and will notify the school as such.

7. I agree to have current contact information available for 2 parents/guardians and 2 emergency contacts should my child need to be sent home from school and will make every reasonable effort to promptly pick up my child(ren) in the event that they become sick at school.

8. I agree that I will send my child to school with a clean mask each day.

9. I will work with my child prior to the opening of school to ease the transition to daily mask wearing.

10. I agree to send my child to school with a water bottle labeled with his or her name.

11. When traveling out of the Charlottesville area, I will consider what level/phase of outbreak our destination point is and will take all measures possible to minimize our family’s risk of exposure of COVID-19, including possible quarantine upon return.

12. I will reinforce the culture of social distancing, mask wearing, and handwashing within our household.

13. I understand that the annual flu vaccine is encouraged for my child(ren) and members within our household.

14. I understand that changes in the status of the pandemic as well as local, state, and federal recommendations may require changes to the aforementioned protocols and requirements and I agree to abide by these changes if and when they occur.