Student Name

COVID-19 Liability Release Waiver

 Due to the 2019-2020 outbreak of the novel Coronavirus (COVID-19), our business is taking extra precautions with the care of every client to include health history review and enhanced   sanitation/disinfecting procedures in compliance with CDC guidance.

 Symptoms of COVID-19 include:
 • Fever 
 • Fatigue 
 • Dry Cough  
 • Difficulty Breathing 

 I agree to the following: 
 • I understand the above symptoms and affirm that I, as well as all household members, do not currently have, nor have experienced the symptoms listed above within the last 14 days. 
 • I affirm that I, as well as all household members, have not been diagnosed with COVID-19 within the past 30 days. 
 • I affirm that I, as well as all household members, have not knowingly been exposed to anyone diagnosed with COVID-19 within the past 30 days. 
 • I affirm that I, as well as all household members, have not traveled outside of the country or to any city considered to be a “hot spot” for COVID-19 infections within the past 30-days. 
 • I understand that The Delta School of Driving cannot be held liable for any exposure to the COVID-19 virus caused by misinformation on this form or the health history provided by each client. 

 Our business is following these enhanced procedures to prevent the spread of COVID-19:

 1. Instructor replies to Health Screening text 1-4 hours prior to beginning a shift certifying
                a) They do not currently have signs or symptoms of a fever or have a temperature that is elevated above 100 F or greater.
                b)They are not known to have COVID 19 and are not known to have come in contact with anyone with COVID 19 in the past 14 days.
                c)They do not currently have the symptoms associated with COVID 19

  2. Instructor avoids touching own face during/between lessons, coughs or sneezes into their own sleeve or elbow, and avoids unnecessary physical contact with students and parents. (No shaking            hands, keeping 6’ social distancing when possible)

 3. Upon arrival at each student’s pick up location, instructor meets student outside of vehicle takes non-contact temperature and has student sanitize their hands and put on mask. In the presence of         the student, instructor wipes all surfaces that have been touched. 

     By signing below, I agree to each statement above and release The Delta School of Driving from any and all liability for unintentional exposure or harm due to COVID-19.
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By checking the box I have read and agree to the terms