By completing and signing this form, you acknowledge and represent that you are the parent or legal guardian for the student listed on this form and confirms your understanding of the following:
1. I authorize and acknowledge that my child will participate in COVID-19 PCR testing (Cheek Swab) at Imhotep Academy at no charge to me.· (If you do not wish for your child to test with Imhotep Academy, your student may obtain testing at an alternate site, at your expense, in order to meet the testing mandate. The test will need to be completed within 10 days of the testing dates. You should not submit this form if you do not want your student being tested at Imhotep Academy.)
2. I acknowledge and understand that testing consists of a saliva sample taken at Imhotep Academy and that the laboratory testing and analysis will be performed by Covid Testing Appointment Lab, LLC·
3. I authorize my child’s test results to be released to Imhotep Academy Administration, Georgia Department of Health, related laboratories, and medical professionals.
4. I acknowledge and consent to Imhotep Academy and Covid Testing Appointment Lab, LLC storing my child’s information obtained for testing and disclosing this information to the Georgia Department of Health as necessary·
5. I acknowledge and agree that I will be contacted by phone call from a representative of the Georgia Department of Health with notification of a positive result. I agree to answer my phone in order to receive test results.
6. I acknowledge and agree to quarantine my child for 10 to 14 days if my child tests positive for COVID-19.
7. I understand Imhotep Academy is not acting as my child’s medical provider, this testing does not replace treatment by your child’s medical provider, and I assume complete and full responsibility to take appropriate action with regard to my child’s test results.
8. I understand that, as with any medical test, there is the potential for a false positive or false negative COVID-19 test result.
9. I acknowledge and agree that a negative test result must be provided to Imhotep Academy Administration in order for my child to return to school in person.
10. I understand that if my child tests positive, he or she must attend school virtually until he or she receives a negative test after quarantining for 10-14 days, at which point he or she may resume class on the Imhotep Academy campus.
11. I understand that if my child test positive I am responsible for keeping up with their school attendance, participation, and picking up assignments as instructed by the administration.