COVID-19 Liability Release Waiver

The World Health Organization has declared the novel Coronavirus (COVID-19) a worldwide pandemic. Due to its capacity to transmit from person-to-person through respiratory droplets, the government has set recommendations, guidelines, and some prohibitions which ATX Classroom LLC (the "Organization") adheres to comply.

To prevent the spread of COVID-19 and reduce the potential risk of exposure to our workforce and clients, I am requiring all families who are participating in-person tutoring to complete this form.

Your participation is important and required to help me take precautionary measures to protect your family and myself. Thank you for your time, consideration, and honest responses.

In consideration of my participation in the foregoing, the undersigned acknowledge and agree to the following:*

I am aware of the existence of the risk that my child's participation in in-person tutoring may cause injury or illness, such as COVID-19, that may lead to death.I have not, nor have any member(s) of my household, experienced symptoms that include fever, fatigue, difficulty in breathing, or dry cough or exhibited any other symptoms relating to COVID-19 or any communicable disease within the last 14 days.I have not been, nor any member(s) of my household, diagnosed to be infected of COVID-19 virus within the last 30 days.

Following the pronouncements above I hereby declare the following:*

I am fully and personally responsible for my child's safety and actions while and during their participation and I recognize that myself and members of my household may be at risk of contracting COVID-19.With full knowledge of the risks involved, I hereby release, waive, discharge the Organization, its members, affiliates, employees, and assigns from any and all liabilities, claims, demands, actions, and causes of action whatsoever, directly or indirectly arising out of or related to any loss, damage, injury, or death, that may be sustained by me or my child related to COVID-19 while participating in any activity while in, on, or around the premises or while using the facilities that may lead to unintentional exposure or harm due to COVID-19.I agree to indemnify, defend, and hold harmless the Organization and Valeria Portugal from and against any and all costs, expenses, damages, lawsuits, and/or liabilities or claims arising whether directly or indirectly from or related to any and all claims made by or against any of the released party due to injury, loss, or death from or related to COVID-19.

I agree to abide by the following policies and procedures pertaining to COVID-19:*

Unless otherwise determined and agreed to by both Valeria and the family, tutor and students must wear masks or face shields that cover the mouth and nose for the entirety of tutoring sessions.If the tutor or anyone in a student’s household is feeling ill, that person must be tested and receive negative results before resuming in-person sessions.If the person tests positive for COVID-19, in-person tutoring will be suspended for at least 14 days. Please send ATX Classroom LLC a copy of all COVID-19 test results (be that negative or positive).All in-person tutoring sessions are subject to change and cancellation in accordance with local, state, and national guidelines.

By signing below I acknowledge that I have read the foregoing Liability Release Waiver and understand its contents; that I have been sufficiently informed of the risks involved and that I give my voluntary consent in signing this Liability Release Waiver as my own free act and deed with full intention to be bound by the same, and free from any inducement or representation.

I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that myself, my child, and members of my household may be exposed to or infected by COVID-19 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 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, tutors and program participants and their families. I hereby release Valeria Portugal and ATX Classroom LLC from any and all claims arising from or in connection with any direct COVID-19 impact while visiting.

This waiver will remain effective until laws and mandates relevant to COVID-19 are lifted.

Email*

example@example.com

Full Name*

First NameLast Name

Agreement*

I agree to all of the above.I agree to use electronic records and signatures.

Signature*

Date Signed*

Date