In the event of a serious accident or illness, I request that the school contact be reached, I request designated RTV Personnel to take or send my child to the hospital specified above. In some circumstances, Emergency Services personnel may determine that another hospital should receive my child from the after school/summer camp program and to be responsible for his/her care. These persons listed have transportation and are immediately available to come to school. I authorize my child's information to be released to any physician caring for my child.

In addition the following actions will be enforced:

FIRST ACTION: Written and signed agreement to adhere to the pick up policy of the program.

SECOND ACTION: Fee assessed and final warning of late pick up action.

THIRD ACTION: Contact The Department of Children and Families and /or The Local Police Department. More than three (3) late pick-ups will result in termination of your child's enrollment in the program.

RELEASE INDEMNIFICATION AND HOLD HARMLESS AGREEMENT
In consideration of participating in Recapturing the Vision International, Inc. ("RTVI") after school program activities, and for other good and valuable consideration, I hereby agree to release and discharge from liability arising from negligence RTVI and its owners, directors, officers, employees, agents, volunteers, participants,andall other persons or entitiesactingforthem (hereinafter collectively referred to as "Releasees"), on behalf of myself and my children, parents, heirs, assigns, personal representative and estate, and also agree as follows:

1. I acknowledge that participating in RTVI activities involves known and unanticipated risks which could result in physical or emotional injury, illness, paralysis or permanent disability, death, and property damage. Risks include, but are not limited to, broken bones, torn ligaments or other injuries as a result of falls or contact with other participants; death as a result of drowning or brain damage caused by near drowning in pools or other bodies of water; medical conditions resulting from physical activity or exposure to infectious diseases such as COVID-19; and damaged clothing or other property. I understand such risks simply cannot be eliminated, despite the use of safety equipment and increased cleaning, sanitation and physical distancing, without jeopardizing the essential qualities of the activity.

2. I expressly accept and assume all of the risks inherent in this activity or that might have been caused by the negligence of the Releasees. My/My child's participation in these activities is purely voluntary and we elect to participate despite the risks. In addition, if at any time I believe that event conditions are unsafe or that I or my child are unable to participate due to physical or medical conditions, then I will immediately discontinue participation.

3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold
harmless Releasees from any and all claims, demands, or causes of action which are in any way connected with my/my child's participation in these activities, or our use of their equipment or facilities, arising from negligence. This release does not apply to claims arising from intentional conduct or conduct that constitutes greater than ordinary negligence. Should Releasees or anyone acting on their behalf be required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify an hold them harmless for all such fees and costs.

4. I represent that I have adequate insurance to cover any injury, illness or damage I of my child may suffer or cause while participating in this activity, or else I agree to bea the costs of such injury, illness or damage myself. I further represent that I/my child have no medical or physical conditions which could interfere with our safety in thes activities, or else I am willing to assume and bear the costs of all risks that may be created, directly or indirectly, by any such condition.

5. In the event that I file a lawsuit, I agree to do so in the state and county where Releasees' faci is located, and I further agree that the substantive law of that state shall apply

6. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.

In the event that I/my child need immediate medical attention for injuries or illness that may occur while participating in a RTVI program, I authorize the RTVI staff togiveme or my child reasonable first aid, and to arrange transport of myselfor my child to a health care facility for emergency services as needed. I understand that I may be asked to isolate myself or my family and may be asked to leave a program early if I display symptom of illness such as COVID-19.

2. I give permission for myself and/or my child to be transported by the RTVI as needed forfieldtrips,inclementweather,orlatepickup.lalsogivemypermissionto participate in walking field trips.

3. I hereby acknowledge that the RTVI will assume that either parent of the child may pick up the child at any time during the program unless there is pertinent court documentation on file at the RTVI that indicates otherwise.

4. I agree to the release of any records necessary for treatment, referral, billing, infectious disease tracking, or insurance purposes. The RTVI receives medical information on campers/participants that may need to be shared with medical providers, insurance carriers, or other governmental agencies as required.

5. If I or my child requires use and administration of an epi-pen, prescription or over the counter medication, it is my responsibility to ensure that the epi-pen and/ or medication are on me or my child or within our personal belongings every day of the program. If RTVI staff is required to administer and use the epi-pen and/or medication, I agree to forever release and discharge the RTVI and its directors, officers, and employees from any and all liability arising out of or resulting from use or administration of the epi-pen and/or medication.

6. I agree to take personal responsibility for myself and my family while participating in this program. Personal responsibility may include but not be limited to; initial temperature monitoring upon arrival, self-monitoring temperatures each day, following social/physical distancing protocols, and following appropriate hand- washing, cleaning and sanitation practicesas defined by the RTVI and for as longas this is deemed necessary for the safety and protection of all participants and RTVI team members by the County medical team and the CDC.

I hereby release all pictures of myself or my child taken by the RTVI for promotional
purposes and programming materials including the RTVI website.

2. I give my permission for the RTVI to administer sunscreen as needed and to change my child's diaper while my child is in their care.

3. I acknowledge that certain sections of this waiver may not apply to me and/or my child and the programs or activities that we have chosen but agree to be bound by any applicable language.

By signing this document, I agree that if I or my child is hurt or our property is damaged during participation in these activities, then I or my child may be found by a court of law to have waived our right to maintain a lawsuit against the parties being released on the basis of any claim for negligence.

I have had sufficient time to read this entire document and, should I choose to do so, consult with legal counsel prior to signing. Also, I understand that this activitymight not be made available to me or thatthe cost to engage in this activity would be significantly greater if RTVI did not utilize waivers as amethod to lower insurance and administrative costs. I have read and understood this document and I agree to be bound by its terms.

Dear M-DCPS Parent,
It has come to our attention that you are interested in your child participating in ReCapturing the Vision, International, Inc. It is important to understand that the organization ReCapturing the Vision, International, Inc is not organized, contracted, staffed and/or hosted by The School Board of Miami-Dade County, Florida. Any information that you are sharing is being done so through a third-party or private organization. Any forms that you are asked to complete are those of that third party organization and not that of M-DCPS. As a parent you should review these forms carefully as you may be waiving certain legal rights for you and/or your child

I desire to participate or allow my child(ren) ("Activity Participant") to participate in one or more voluntary extracurricular activities being held on the campus(es) of the School Board of Miami-Dade County, Florida ("School Board"). I acknowledge that the novel coronavirus known as COVID-19 has been declared as a worldwide pandemic and is believed to be contagious and spread by person-to- person contact, including in Miami-Dade County. I further acknowledge that federal, state, and local agencies recommend social distancing and other measures to prevent the spread of COVID-19.

The School Board will have third-party organizations ("Organizations") conducting certain extracurricular activities, including summer camps, on its campus(es). I understand that if I or my child(ren) choose to participate in these Organizations' activities (hereinafter "Activity"), the Activity will be controlled, organized, contracted, staffed, and insured independent of the School Board, and will be conducted with the safety protocols these Organizations deem appropriate under the circumstances at the time, which may be subject to change. I understand that the School Board will not be responsible for implementing, supervising, or informing the Activity Participant(s) of this Organization's safety protocols, and that it is solely my responsibility, as well as the Activity. Participant's, to adhere to all state, federal, and local safety protocols, as well as those the Organization provides.
In an effort to ensure the safety and wellness of our school community, I understand the importance of Activity Participants, including my child(ren), being healthy and safe when they participate in the Activity. By signing below, I agree that I will:

Perform daily temperature checks on my child(ren) to screen for fever before arrival to the Activity. Fever is defined as a temperature over 1 00.4 For 38.0 C. If my child(ren) has a fever, I will not permit my child(ren) to participate in the Activity until he/she has been without a fever for at) east 72 hours.

Make a visual inspection of my child(ren) for signs of illness which could include fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea, flushed cheeks, rapid breathing, or difficulty breathing (without recent physical activity), fatigue, or extreme fussiness. If my child(ren) has exhibited any of these signs or symptoms, I will not permit my child(ren) to participate in the Activity until he/she has been without signs or symptoms for at least 72 hours.
FM-6103 Rev. (07-20)

Confirm that my child(ren), before and while participating in the Activity, has not tested positive for COVID-19 in the past 14 days, is not waiting for test results based on a diagnosed or suspected case of COVID-19, and has not within 14 days returned from an area subject to CDC Level 3 Travel Health Notice.

Confirm that my child(ren), before and while participating in the Activity, has not been in contact with someone who has either tested positive for COVID-19 in the past 14 days, is waiting for test results based on a diagnosed or suspected case of COVID-19, or has returned from a highly impacted area subject to a CDC Level 3 Travel Health Notice. If my child(ren) has been in contact with such a person, including from the same household, I will not permit my child(ren) to participate in the Activity until 14 days have elapsed since the time of contact.

Promptly pick up my child(ren), or arrange for pickup, if signs or symptoms of illness are present. I understand that children are to remain home until illness-free for at least 72 hours without the use of medicine.

By signing this document, I acknowledge and affirm all the statements above. I also understand that I or my child(ren) may unavoidably be exposed to or infected by COVID-19 as a result of participation in the Activity, and that such exposure or infection may result in personal injury, illness, sickness, and/or death. I understand that the risk of exposure or infection may result from the actions, omissions, or negligence of myself, my child(ren), these Organizations, School Board staff, volunteers, or agents, other Activity participants, or others not listed, and I acknowledge that all such risks are known to me.

In consideration of my and/or my child(ren) being able to participate in the Activity, I, on behalf of myself and my child(ren), as well as anyone entitled to act. on my behalf, hereby knowingly and voluntarily forever waive, release, and hold the School Board and its employees and agents harmless from any and all claims, suits, liability, actions, judgments, attorneys' fees, costs, and any expenses of any kind resulting from injuries or damages, grounded in tort or otherwise, that I and/or my child(ren), or my or our representatives, sustain during or related to my child(ren)'s participation or involvement in the Activity.

If this Waiver, Release and Hold Harmless or any portion thereof is determined to be invalid or unenforceable for any reason, the remaining provisions of this Waiver, Release, and Hold Harmless, as well as any other agreement(s) concerning me or my child(ren)'s participation in this Activity, shall be unaffected and remain in full force and effect.

The Vision Smart Kids After School Program Parent Handbook consists of the following policies and procedures:

• Confidentiality policy
• Discipline Policy
• Transportation Policy
• Late Pick-Up Policy
• Health Policy
• Know Your Childcare Brochure
• Influenza Virus Brochure
• Distracted Driver Brochure