Columbia Grammar & Preparatory School (“CGPS” or the “School”) has implemented a return-to-school plan to hold live, on-campus classes for the 2021-2022 school year As an additional safety measure and in order to facilitate CGPS’s ability to offer in-person, on-campus learning, the School is offering on-campus COVID-19 testing to monitor for the presence of COVID-19 in the School community (the “COVID-19 Testing”). The undersigned Employee, who will be participating in the COVID-19 Testing, agrees to the terms and conditions below:

1. Voluntary Participation and Consent to Participate: Employee understands that their participation in on-campus COVID-19 Testing is entirely voluntary, and consents to participate in the COVID-19 Testing. Employee acknowledges that employees who test positive for COVID-19 will be further referred to their health care provider. Employee further understands that such employees will not be permitted to return to campus until such time as their healthcare provider so advises. Employee understands that the School is not acting as the Employee’s healthcare provider and that the COVID-19 Testing offered by the School does not replace treatment by the Employee’s healthcare provider.

2. Communication of Results: Results of the COVID-19 Testing will be made available to both the Employee and the School. The School may further disclose test results and associated information to appropriate county, state, or other governmental agencies, such as the Department of Health, and any other regulatory entities as may be required by law, rule or regulation.

3. Assumption of the Risk: Employee understands and agrees that the School’s COVID-19 Testing is but one component of the measures it has implemented to mitigate the risk of the transmission of COVID-19 on campus. CGPS is not providing any clinical diagnoses but has partnered with a third-party provider who will facilitate ordering the COVID-19 Testing for those who choose to participate. Further, CGPS is not conducting the COVID-19 testing, but instead is only collecting the samples as provided by members of the School community, with testing to be conducted by the designated lab(s). CGPS makes no representations or warranties as to the accuracy of the testing provided, and Employee assumes the risk that the testing provided may be faulty, and may result in either false positives or false negatives.

4. Waiver and Release of Liability: Employee releases the School, its Trustees, employees and agents from all claims, liability and damages that Employee may have for personal injuries, illnesses, medical expenses, or other loss resulting from Employee’s participation in the COVID-19 Testing. Employee agrees that this release includes personal injury, illness, medical expenses, or other losses caused by or resulting from negligence, active or passive, of the School, its Trustees, employees and agents; however the release does not apply to liability for gross negligence, willful injury, or fraud, and is not intended to release the School’s insurers, if any, or non-agent third parties of any responsibility for any claims that may otherwise be asserted.

5. Miscellaneous: The releases contained within this Authorization and Release from Liability are for the benefit of CGPS and are binding on the Employee. This Authorization and Release from Liability shall be governed by the laws of the State of New York. If any clause, sentence, paragraph or other provision of this Authorization and Release from Liability is, for whatever reason, deemed void, or otherwise unenforceable, then such language shall be severed and the rest of the Authorization and Release from Liability shall remain in full force and effect.

By signing this Authorization and Release from Liability, Employee acknowledges and represents that they have read the Authorization and Release from Liability, fully understand it and agree to its provisions, and sign it voluntarily as their own free act on their own behalf. No oral representations, statements, or inducements apart from the foregoing Authorization and Release from Liability that has been reduced to writing have been made and no modifications or alternations may be made to this form.