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Florida High School Athletic Association Revised 07/20

Consent and Release from Liability Certificate for COVID-19 (Page 2 of 5)
This completed form must be kept on file by the school. This form is valid for 365 calendar days from the date of the most recent signature.

School: School District (if applicable):

Coronavirus Information
Coronavimses are a large group of viruses that can cause illness in animals and humans. Sonic coronavimses eonssnonly circulate in the United Stales and sisually cause tipper respiratory
symptoms such as cough or ninny nose, although some can cause snore severe illness, TIme 2019 novel (new) coronavints (SARS-CoV-2) causes sIte illness coronavinis disease 2019 (COVID- 19).
COVID. I Owas originally identified in Wuhan, China, and is nosy considered a pandemic as isis present tlsrougltout the world, imscluding Isere in Florida. Coronavimses like COVID- 19 are most
onen spread through tIme air by costglsing or sneezitsg, close personal contact (ismclssding touching and shaking hands), or toticiming your smose, momstts, or eyes before washing your sands. Al Isis
timtme, tIme risks of beco:ssittg infected fromn organized sports activities are unknown. There is currently no vaccine so prevent COVID-l 9. TIme best way so prevent illness is so avoid exposure so the
virus tand avoid exposing otlter people). According to tlse CDC, the more people a ctsild or coacts imsteracts witls, ttme closer ttte ptsysicat internctiom,, time snore sharing ofequipsnent there is by
mstltiple players, amsd site longer sItar interaction, tIme Itiglmer the risk ofCOVlD— 19 spread.

Signs and Symptoms of COVID-19:

People wills COVID-19 Isave mad a wide range ofsymptomsss reported ranging from mild symptoms to severe illness. Sytnptomas nay appear 2-14 days after exposure to the virus, It is
—

important so note, it nay be possible for sonseomse to be a carrier of COVID-l 9; wlsereby, they do not Imave any synsploms bits still nay he contagious to otlsers, Comnsnoss symsmptomns of
COVID- 19 incltsde the following:
Recent loss of taste or ssssehl Fever or cIsill
Cough Sltonness of breatlm or ditimesslsy breathing
Fatigsse Muscle or body arIses
Headache Sore tlsroat
Congestion or nmnny nose Nasssea or vomiting
Diarlsea Dizziness or unexplained rasls
Tlsms list does not include all possible sysssptosns. TIse CDC is a tssefstl reference and will continue to smpdate thsis list of symnptosns as mtsore is teamed about COVID.t 9.
How to prevent tand prepare for COVID-)9:

I’rartice smscisl (physical) il ista ncing:

If yoms are arotrttd ottser people, keep at least 6 feet between you wlsett possible. Avoid hugs, Isandsisakes, large gallserissgs and close quarters. Tlsese recosnsnendatiosss cam, be extremssely
challettging itt art organized atltlesic ettvirontnent and slsossid ise ttsorDtsgisly considered witen deciding to panicipate in school sports.
Why? Tise virus is spread mainly frosts persoss-lo-person. When sosneotse coughs or ssseezes, sisey spray ssnall liquid droplets from titeir nose or snouths, wisiclm stsay contain site virus Ifyots are
too close, you can breatlse its tIme droplets cos,taim,ing site coronavims if tlse person cougising Isas site disease. Participatiost in sports programs can cause an increase in forcefutl respiratiotts tlsat
nay travel greater tItus 6 feet atsd titerefore, can increase site risk of spreading COVID’ 1910 a partieipatst or team.

Vcar a race covering in public: Cover your snosstls and nose wilts a face covering wIscn arosss,d otlscrs and out in public, and whsenever practical dtsring sports activity.
Vlsy? Yost could spread COVID-l 9 to otlsers even if you do slot feel sick. Tise dolls face cover is ‘seam’s to protect ottser people in ease you are infected. Variouss smylea of face coverings are
availatsie frosri dolls to sssrgical’styte mssasks. TIse mask slmossld fit cotnfortably and be wont properly over the nose amsd snosmtlm..

Practice strict hand hygiene.

Why? Tise via’s cast smurvive on certain smuffaces for several sours. Wash yosur Isands often. Yost can use regsslar soap and water as long as yost scrub for at least 20 seconds. Yost can also use
sand sam,itizer contaisnmsg at least 60% alcohol.

Avoid touchsing eyes, nose and mouth.

Why? I-lands buds many surfaces and can pick sup vinsses. Once cotsiaminated, sands can transfer Ilse virus to youur eyes, nose or mssosutls. Cover youur tttosstlm and nose wills a tissue or the
isaside of your elbow wtsen yosu coughs or sneeze.

Clean anti disinrect “higis-tusocls” surfaces. Clean AND disinfect fresjsmently totuclted surfaces at least daily. Tlmis incluudes tables, doorknolss, liglmt switclmes, counuertops, Isandles, desks,
pluosses. keyboards, toilets, faucets, and sitsks. If surfaces are diny. first clean witlt detergent or soap and water, and tlsen disismfeet. Most common EPA-registered Isotuseheld disitsfertastts,
ds luued lsouuselmol d bleacim solsut i osts, and ateoltol soltutiosss wills at least 70% alcohol will work.

What do I do if I think I was exposed to an individual with COVID-19?

Watch ror symptoms: /‘esspk’ with (Ol’/D-19 /sare reported a wide range sufsynmptotssx rangtngfrasss ,ssilsI to serere. Sytssptsutn.s tmtay appear 2-14 days sifter ex/xs.cmire to I/se slots.
• Contact your personal healttt care provider or use Itse CDC’s self-etseeker (CDC.gov) to help snake decisions and seek appropriate medical care regarding COVID-19.
• Talk to yosrr lsealtlmcare provider about any other sysoptorns tlsat are severe or concenling to you.
• Ifyoss are concemed ahout yotur status, get tested for COVID-19 riglmt away. Eves, ifyou don’t Isave syssmptossss, you nay be able to be tested after as exposure,.
• Furthsenrsore, follow your selsool proceduures for notification.

What dcl do if I’m sick?:

Do not go to seisool or sports practice ifyosu are sick. After speaking with your personal hiealttscarr provider, notify your school and your coactses. Treatment is typically tsver tise
csmunter medications to help your symptoms. Currently, tlmere are no specific asasiviral treassnemsls recos,msnem,ded for COVID— 19.

Ifyosm are sick with, a fever (100 4”F/38T or tsigtser) or cosmglm, have trosuble breatlsing, or ssuspect you save COVID- 9. Isere’s how to help prevesat time disease from spreading to people in
your l,otne and comaasnessity.

SELF-ISOLATE AT IIOME
— STAY AWAY FROM OThERS
r GET A COVID-t9 l’CR TEST

Participation in orcanized sports during the COVlfl—19 Pandemic: Participation in organized sports during site COVID-19 Pmmdes,,ic can lead to an increased risk
of exposure for all stakelmolders, Sclsools are creasing comnprelmensive plans to reduce tltese risks, Itowever, none of tlsese snitigation etTons can guarantee cosnphete safeuy. Schools will ask
all staketsolders for ttseir support and compliance to keep athsletic cosnpetition as safe as possible. TIse NFHS and otlmer orgamsizatiosss isave created slratifications so Iseip classify sports by
risk category Sotne sports are classified as Imighm risk becassse Itsey Isave a luigiser rate of potential esposture versus low risk whirls Imas a lower exposure rame To become store aware of
wlmat risk category specific sports are classified, visit: huttns:Iiwsnv,nflms oru/media/8 I 2287/2020-nflts-euidanee-for—openine.utp-hielu-sehool-ptluleties—and-activilies-pfl,s-smac-may—
ii 2020-flpal,ndf

Statement of Student Athlete Responsilsility

Parents and students shoulst be aware of iareliminamy evidesmce tlsat suggests student-athletes are at an increased risk of cmuntracting COVII)- 19 when participating in shorts,
especially thuse sports where physical distancing is not always possible. Please review all risks befure allowing your cisilsl/ward to laaflicipate in the srlsool spttrts program. There
are relaorts of kids wlsts Isave becmmme sick and lmsye died doe to Otis stew cantaginus ttisease. There imave Item reports that lumng-term health cusncerns can affect individuals, inchutting

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lads who have become infected with COVID—l 9. These lang—term health issues may include, but not limited Ia; injury to the heart muscle, lung damage, lslood clotting disorders, or
dealts. A specific illness has impacted children with COVID—l9 called Multisystem Inflammatory Syndrome of Children (MIS—C). Furttser research sn this losic is needed before
any conclusions can be drawn.

I accept responsilsiliey for participating in school-based screenings for COVIDI 9 and for reporting all symptoms of illnesses to my jsarents, team doctor, athletic trainer, or caaches
associated wilh my sport including any signs and symptoms ofCOVID-l9 and also any close contact or exposure to COVID-l9 to the Isest of my ability. I have read and understand
the above information on COVID-19. twill inform tlse supervising enacts, athletic trainer or team physician immediately if I experience any ofthese symptams or witness a
teanimate witls these symptoms. Furthermore, I have been advised of the dangers ofpahicipatioo for myselfand that olmy child/ward.

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Name of Sludent-Atislete (printed) Signature of Student-Athlete Dale

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Name of Parent/Guardian (printed) Signature of Parent/Guardian Date

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Name of Parent/Guardian (printed) Signature of Parent/Guardian Date

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