COVID-19 Teacher Waiver RITES Teacher Assumption of Risk Waiver COVID-19 Section 1: WaiverCoronavirus (COVID-19) has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread primarily from person-to-person contact but may also spread from surface contact. Consistent with the State of Rhode Island’s plan to allow businesses to re-open, Rhode Island Tutorial and Educational Services, Inc. (“RITES”) has reopened for in-person services and has implemented preventative measures recommended by the State of Rhode Island to reduce the risk of spread of COVID-19. Despite those measures, RITES cannot guarantee that the undersigned will not come into contact with other individuals who are infected with COVID-19 or that any Participant will not become infected with COVID-19. By signing this Waiver and participating in activities and/or visiting RITES, or interacting with RITES’ students/parents ("Participants"), the undersigned, on behalf of herself/himself: 1. Assumes the risk that a s/he may be exposed to or infected by COVID-19 by working at the RITES facilities or participating in RITES activities with students/participants at the students'/participants' homes, or her/his own home office 2. Assumes all of risks associated with COVID-19 resulting from attendance at RITES and participation in activities at RITES, including any illness, injury, liability, loss or expense s/he may suffer or incur (“Claims”); and 3. Agrees that s/he is personally responsible for her/his own safety and actions while using RITES services and facilities, visiting students'/participants' homes or within her/his own home office 4. Agrees to comply with all RITES policies and rules, including but not limited to all RITES policies, guidelines, signage, and instructions 5. Understands that the risk of becoming exposed to or infected by COVID-19 while providing RITES services may result from the actions, omissions, or negligence of Participant and others, including, but not limited to, RITES employees, volunteers, and program participants and their families 6. Releases, covenants not to sue, discharges, and holds harmless RITES, its employees, agents, and representatives, of and from all Claims. Name of RITES teacher* First Last Date* Date Format: MM slash DD slash YYYY RITES Teacher Consent*By signing below, I understand this constitutes a legal signature confirming that I acknowledge and agree to the terms on this form. Please type your first & last name below to serve as an Electronic Signature.Section 2: Procedure ListPlease read and check off each box.* Select All I have confirmed with RITES that the families I am working with have signed the liability waiver. I will wear a mask or face covering. I have received hand sanitizer, face covering and cleaning solution from RITES. I will check my temperature each day before tutoring. I will ask the questions on the COVID-19 Screening tool to each family once a week. (This is mandatory from the CDC.) If a student meets more than once a week, I will ask if there are any updates to the COVID-19 screening tool If working in locations not at the learning cent, I will arrange a pick-up and drop-off procedure that allows me and the parents to keep a 6-foot distance. If I work at the learning center, I will follow the procedures mandated for working at the learning center. I will allow sufficient time between students so that students coming and leaving are not present at the same time. I will allow sufficient time between students so that I have time to clean between students. I will clean all areas touched by students using a disinfectant cleaning solution. I and the student will use hand sanitizer before each session. I will suspend tutoring if I test positive for COVID-19 or exhibit any symptoms, risk factors as listed in the COVID-19 screening tool and advise my families. I will have a separate *set of materials and books for each individual student. Each student will have his/her own bag or box to store materials and books. *RITES can help provide the extra materials needed to give each student his/her own set. Agreement to Follow Procedures*I have read, understand, and agree to adhere to the above procedures. Please type your first & last name above to serve as an Electronic Signature.
