In consideration for participation in Philander Smith College’s events, classes, and housing programs, including but not limited to the use of facilities, equipment, grounds, and/or personnel, I, the undersigned participant (Participant) understand, acknowledge, agree, and represent and
warrant as follows:
1. I am over the age of 18 and I have read and understand this form. If I am under the age of 18,
I understand that my parent or legal guardian will be required to sign this form on my behalf.
2. I understand that the novel coronavirus, COVID-19, has been declared a worldwide pandemic
by the World Health Organization. COVID-19 is extremely contagious and is believed to
spread mainly from person-to-person contact. As a result, federal, state, and local governments
and federal and state health agencies recommend social distancing and have, in many locations,
curtailed the number of people who may congregate together or otherwise required individuals
to follow strict social distancing guidelines to avoid close contact with one another.
3. I understand that although Philander Smith College has taken measures aimed at reducing the
spread of COVID-19 in its community, it is impossible to guarantee the efficacy of these
measures, or that I will not become infected with COVID-19. Further, I understand that
attending the College, participating in College athletic camps, lead classes, trainings, or labs
and residing in on-campus housing could increase the risk of contracting COVID-19. I
acknowledge that it is my obligation to follow all social distancing guidelines promulgated by
the College, the Centers for Disease Control, and the Arkansas Department of Health as
applicable, and to ensure that my hygienic practices such as hand washing and wearing face
masks conform to same.
4. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by attending the College 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 COVID19 at the College may result from the actions, omissions, or negligence of myself and others, including, but not limited to, College employees, other students, vendors or affiliates and their families.
5. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my attendance at the College or participation in Philander Smith College activities, athletic camps and any on-campus housing.
6. I hereby release, covenant not to sue, discharge, and hold harmless the College, its employees, agents, and representatives, of and from the claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto (Claims). I understand
and agree that this release includes any Claims based on the actions, omissions, or negligence of the College, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any College services to the greatest extent afforded under the laws of the State of Arkansas. My signature indicates I release Philander Smith College and/or any of its employees from any and all liability to the extent contemplated herein.
7. I hereby authorize the College staff to act for me, according to their best judgement, in any medical emergency.
8. I understand that I am personally responsible for my own medical expenses and insurance, and that I will abide by the College’s policies and procedures with respect to social distancing and safe hygienic practices.
Developed: July 15, 2020 [pc] Page 2 of 2 Approved for Use: August 12, 2020