Health Declaration

How are you feeling today?

In relation to the Youth Football Camp event, hosted by 804 Sports Association, Inc. occurring on June 4,

2022, Hermitage Highschool 8301 Hungary Spring Rd. Henrico, VA 23228.

I, __________________________________ [Participant or Participant’s Guardian Name], recognize that

are risks involved in participating in today’s activities and hereby assume all risk of injury, harm,

damage, or death in connection with my or my child’s participation in this activity. I understand and agree

that neither 804 Sports Association, Inc. nor its trustees, officers, directors, employees, agents or

representatives may be held liable in any way for any injury, harm, damage, or death that may occur to

me as a result of my participation in this activity and hereby release 804 Sports Association, Inc., its

trustees, officers, directors, employees, agents and representatives from any liability. To the fullest extent

permitted by law, I agree to save and hold harmless 804 Sports Association, Inc. its trustees, officers,

directors, employees, agents and representatives from any claim arising out of my or my child’s

participation in the activity. I authorize 804 Sports Association, Inc. through its trustees, officers, directors, employees, agents or representatives to render or obtain such emergency medical care or treatment for me or my child as may necessary should any injury, harm or accident occur to me while participating in this activity. I am not aware of any injury, illness or other health related issues that would restrict or limit my or my child’s ability to be involved in today’s sports related activities. I agree to assume all risks and expenses due to an injury that may occur as a result of my or my child’s involvement in today's sports related activities. I understand that while 804 Association Sports Association, Inc. has taken every actionable measure to make this event completely COVID safe. However, I acknowledge that participation includes possible exposure to COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death exist; and, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM NEGLIGENCE, and assume full responsibility for my participation; and I

willingly agree to comply with the stated and customary terms and conditions for participation as regards

protection against infectious diseases. If, however, I observe any unusual or significant hazard during my

presence or participation, I will remove myself or my child from participation and bring such to the

attention of the nearest official immediately. This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and the provisions in this waiver/release to my child including the risks of presence and participation explained and his/her

personal responsibilities for adhering to the rules and regulations for protection against

communicable diseases. Furthermore, my child understands and accepts these risks and responsibilities.

Thanks for submitting!