CLIENT INFORMED CONSENT AND WAIVER FOR IN-PERSON SERVICES DURING COVID-19
This document contains important information about our decision (SOAR and yours, together) to conduct in-person services in light of the COVID-19 public health crisis. Please read this carefully as this document contains important information about your rights and safety. If you have any questions after reading this, a SOAR team member will be able to answer them. When you sign this document, it will be an official agreement between you and SOAR.

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Adresse e-mail *
Today's Date:
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Parent/Guardian Full Name *
Child's First & Last Name *
Guidelines for In-Person Activities
Parents/Guardians, Youth, and SOAR team members/volunteers must agree to the following:

1. Understand, if a Parent/Guardian and Youth decide to meet in person with a SOAR team member/volunteer, there are risks to spreading and/or contracting COVID-19. Following these guidelines can help reduce risk, but risk cannot be eliminated.

2. If a Youth, SOAR Coach/Volunteer or someone in the household of the previously named parties test positive for COVID-19 and/or are diagnosed with COVID-19, the other parties must be notified, and in-person activities are not allowed until the infected party is no longer infectious, according to the CDC guidelines.

3. When an in-person activity occurs, the following is expected:
-All parties will avoid being around people who are more likely to get very sick from COVID-19.
-All parties will avoid contact with people who have suspected or confirmed COVID-19
-All parties will wash or sanitize hands frequently.
-All parties will cover nose and mouth as best possible when sneezing, coughing, eating, etc.
-All parties will avoid sharing food, drink, personal hygiene, medications, and other items that could be contaminated/spread infection with each other.

4. SOAR Youth and Parents/Guardians will be informed if SOAR expectations/restrictions change according to CDC guidelines and state or municipal orders.

If you decide at any time that you would feel safer not participating in an activity, we will and do respect that decision.
Your Responsibility to Minimize Your Exposure
To obtain services in person, you agree to take certain precautions (listed below) which will help minimize the risk of exposure, sickness, and possible death for yourself, the SOAR team, your family, and other clients with which we work.
You will only attend an in-person activity if you are symptom free and have been symptom free for the appropriate amount of days, according to current CDC guidelines: *
You will wash your hands or use alcohol-based hand sanitizer frequently, when it is available. *
If you, someone in your household, or someone with whom you have had contact has been exposed/infected with COVID-19, you will notify the SOAR team asap. *
If someone from your household tests positive for COVID-19, you will notify the SOAR team immediately and all in-person activities will be canceled until the person is no longer infectious, according to current CDC guidelines. *
If you experience any of the following symptoms, you will notify the SOAR team ASAP: fever of 100 degrees Fahrenheit or higher, shortness of breath, dry cough, sinus congestion, sore throat, nausea, vomiting, diminished sense of taste or smell.   *
Our Commitment to Minimize Exposure
Our organization has taken steps to reduce the risk of spreading the coronavirus and we have posted our efforts on our website.  Please let us know if you have questions about these efforts.
If a SOAR Team Member Is Sick:
You understand that SOAR is committed to keeping you, our team members, all of our youth and their families, and our community safe from the spread of this virus.
If a SOAR team member/volunteer tests positive for the coronavirus, we will notify you immediately so that you can take appropriate precautions.
Your Confidentiality in the Case of Infection
If you have tested positive for the coronavirus, SOAR may be required to notify local health authorities that you have been in proximity of others in our organization and participating in activities with our community partners. If SOAR has to report this, SOAR will only provide the minimum information necessary for their data collection and will not go into any further details.  By signing this form, you are agreeing that SOAR may do so without an additional signed release.
Risks of Opting for In-Person Services
You understand that by participating in any in-person SOAR activities, you are assuming the risk of exposure to the coronavirus (or other public health risk). You further understand that there is a risk of contracting the virus simply by being in the presence of the SOAR team members, SOAR Volunteers, other SOAR clients, and our community partners, even though standard precautions are being taken. This risk may increase if you travel by public transportation, cab, or ridesharing service.
Informed Consent
My signature below indicates that I am choosing in-person, face-to-face activities at my own discretion, not under force or duress from any other person. I further understand that this agreement supplements SOAR-Seeing Our Adolescents Rise’s Disclosure Statement to which we agreed to when my child began the SOAR program.

I HAVE READ THE ABOVE WARNING, WAIVER, AND RELEASE AND UNDERSTAND THAT I GIVE UP SUBSTANTIAL RIGHTS FOR MYSELF AND/OR MY MINOR CHILD(REN) BY SIGNING IT, AND KNOWING THIS, SIGN IT VOLUNTARILY. I AGREE TO IN-PERSON, FACE-TO-FACE EVENTS/MEETINGS/SESSIONS/APPOINTMENTS, KNOWING THE RISKS AND CONDITIONS INVOLVED AND DO SO ENTIRELY OF MY OWN FREE WILL. I UNDERSTAND THAT I AM WAIVING CERTAIN LEGAL RIGHTS THAT I OR MY MINOR CHILD(REN) MAY HAVE. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE, OR, IF I AM UNDER 18 YEARS OF AGE, I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENTS/GUARDIAN AS EVIDENCED BY THEIR SIGNATURES BELOW.
Please accept or decline the information above: *
Electronic Signature Agreement
By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual/handwritten signature on this Agreement. By selecting "I Accept" using any device, means or action, you consent to the legally binding terms and conditions of this Agreement. You further agree that your signature on this document (hereafter referred to as your "E-Signature") is as valid as if you signed the document in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature, and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature or any resulting agreement between you and SOAR - Seeing Our Adolescents Rise (hereafter referred to as your "SOAR". You are also confirming that you are the parent/guardian authorized to enter into this Agreement. You further agree that selecting "1 Accept" constitutes your agreement to be bound by the terms and conditions of these Disclosures and Agreement as they exist on the date of your E-Signature on this form.
Consent to Electronic Delivery
By selecting the “I Accept” button, you specifically agree to receive, obtain, and/or submit any and all SOAR documents and information electronically. These documents and information will be collectively known as "Electronic Communications," and will include, but not be limited to, any and all current and future required notices and/or disclosures or consents concerning SOAR clients, team members, volunteers, interns, and/or parent/guardian, as well as such documents, statements, data, records and other communications regarding your interactions with the SOAR organization. You are acknowledging that you are able to use SOAR's website and are able to retain Electronic Communications by printing and/or downloading and saving this Agreement and any other agreements, Electronic Communications, documents, or records that are signed using your E-Signature. You accept Electronic Communications provided via email as reasonable and proper notice for the purpose of fulfilling any and all rules and regulations, and agree that such Electronic Communications fully satisfy any requirement that communications be provided to you in writing or in a form that you may keep.
Definitions
• Electronic means technology having electrical, digital, magnetic, wireless, optical, electromagnetic, or similar capabilities.
• Electronic Signature means an electronic symbol or process attached to, or logically associated with, a record and used by a person with the intent to sign the record.
   
• Client File means the paper and/or electronic record pertaining to the client, including but not limited to the verification worksheet and all documents used to determine the client’s eligibility for SOAR services.
• System means a data processing or client information system used to create, store, sign, retrieve and/or manage the documents or records that constitute the client file.
• System Rules mean rules that apply to all participants using a particular system. For example, such rules might cover issues relating to access rights, distribution of system risk, sending and receiving electronic documents, intellectual property rights, and remedies for breach of system rules.
Paper version of Electronic Communications
You acknowledge and agree that you may request a paper version of the verification worksheet or other documents by printing or saving a copy to your computer and/or by contacting a SOAR team member directly.
Revocation of electronic delivery
You have the right to withdraw your consent to submit communications via emailing SOAR or in writing at any time. You acknowledge that you are aware this action may delay the process of reviewing your file or working with the client. If you wish to withdraw your consent, you will contact a SOAR team member directly or email us to let us know that you will be forwarding a written request.
By electronically signing below
We recommend that you print a copy of this Agreement for future reference.
At the end of this document, you will be asked to provide an electronic signature.
Clients and their parents/legal guardians are urged to carefully read the terms and conditions of this Agreement. Please keep all records relating to this Agreement and print or make an electronic copy of the Terms and Conditions.
I understand and agree to each and all of the Terms and Conditions in this SOAR - Seeing Our Adolescents Rise Consent for Use of Electronic Signature Agreement. My electronic signature is legally binding. Please check the appropriate box and provide your signature.
Please accept or decline the information above: *
SOAR may change the above precautions if additional local, state or federal orders or guidelines are published. If that happens, SOAR will talk about any necessary changes.  Please type your FULL NAME below to acknowledge that you have read and understand the above precautions:
Please Sign: Child's Full Name *
 Please Sign: Parent/Guardian Full Name *
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