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Acknowledgement Form

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ACKNOWLEDGEMENT REGARDING COVID-19

 

I, the parent/guardian named below, intend to have my student(s) receive instruction in-person and on-campus at Blackwell Consolidated Independent School District (“District”) and/or to utilize the District’s transportation system during the 2020-2021 school year. Additionally, my student(s) may participate in one or more of the BCISD athletic programs. As a result, I hereby acknowledge, affirm and agree to the following:

 

1.      I am familiar with the Blackwell CISD’s Return to School Plan that contains health and safety measures concerning the Novel Coronavirus Disease (“COVID-19”). I acknowledge and understand that the circumstances and symptoms regarding COVID-19 are changing from day to day and that, accordingly, the District’s health and safety measures will likely be modified and updated. I agree to accept full responsibility for familiarizing myself with the most recent District health and safety updates.

2.      I acknowledge that I am aware that, by choosing to have my student(s) receive instruction in-person at District facilities or by choosing to utilize the District transportation system for their transportation to and from school and/or to and from school events, there is a risk that my student(s) will be exposed to COVID-19 and/or any mutation or variation thereof. I am also aware that such an exposure can occur either directly or indirectly whether or not a mask, gloves or other personal protective equipment are worn and that the District cannot guarantee that there will be no exposure to COVID-19 and/or a mutation or variation of COVID-19 despite the health and safety measures implemented by the District. I further understand that anyone, including a healthy person, is susceptible to contracting COVID-19 and/or a mutation or variation of COVID-19.

3.      I further acknowledge and understand that the District will not be able to strictly follow the Centers for Disease Control COVID-19 guidelines, Texas Education Agency COVID-19 guidelines, or other guidelines related to COVID-19 established by any other governmental entity at all times.  For example, social distancing will not always be possible on buses or other school transportation vehicles, during classroom instruction, at lunch time, or during other times in the instructional day.

4.      I further acknowledge and understand that my student(s) may be exposed to COVID-19 and/or any mutation or variation of it if my student(s) participate in District extra-curricular activities such as sports, band, ag, or other UIL competitions.  It is understood that social distancing and other mitigating measures will not always be possible or practical during practices, games, performances, or other extra-curricular activities.

5.      I have independently evaluated and reviewed the risks of my student(s) being exposed to or infected by COVID-19 and/or a mutation or variation of COVID-19 and have determined, with full knowledge and acceptance of the risks, that my student(s) will receive instruction in-person at District facilities and/or will utilize the District transportation system.  I have further determined that if my student(s) participate in District extra-curricular activities, he/she/they do so with my full knowledge and acceptance of the risks of my student(s) being exposed to COVID-19 and/or a mutation or variation of COVID-19.

6.      I understand and acknowledge that the District cannot eliminate the risk of exposure to COVID-19 and/or a mutation or variation of COVID-19 and I fully and knowingly agree to ASSUME ALL RISKS to my student(s) associated with my choice to allow my student(s) to receive instruction in-person at District facilities, to utilize the District transportation system, and/or to participate in District extra-curricular activities, including the risk of exposure to or the infection of COVID-19 and/or a mutation or variation of COVID-19 and any risk of illness, bodily injury, permanent disability and/or death related, directly or indirectly, to COVID-19 and/or a mutation or variation of COVID-19.

 

IN SIGNING THIS DISCLAIMER, I ACKNOWLEDGE AND REPRESENT THAT I have read the DISCLAIMER, understand it and sign it voluntarily as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written DISCLAIMER, have been made.

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