WLAOTC Home | Site Map

COVID Online Waiver - Informed Consent Form

These forms must be filled out by the handler before the start date of the class. The "Participant" is the adult handler or the guardian.

Due to the conditions created by the COVID pandemic, we are required to complete and keep this form on file as part of our permit agreement. A second form to be delivered to the Parks and Recreation department will follow. Both forms contain information and waivers based on COVID restrictions. Refusal to check or initial the forms will make you ineligible to take our classes. Your checking the boxes on these forms is the equivalent to initializing or signing the form.

After clicking on submit, a print friendly copy of the form will appear. You may use the the capabilities of your electronic device if you wish to print or save a copy for your records.

Informed Consent Form

Dear Participant,
The State of California recently announced that effective February 26, 2021, moderate -contact and highcontact youth and adult recreational sports may resume, including competitions, if permitted by local health authorities and if in compliance with both Los Angeles County and State requirements for these sports.

West Los Angeles Obedience Training Club Inc. is taking reasonable measures to prevent the spread of COVID-19 infection, including tracking/tracing, and following applicable state and County public health orders and protocols. However, the possibility of transmission cannot be eliminated. participants must be aware of and acknowledge the risks before participating in classes.

By initialing and signing this Informed Consent Agreement, you acknowledge, accept, and agree to all the following (Participant and, if the Participant is a minor, Parent/Guardian Must Initial and Sign):


● Participant will not attend meetings, practice and/or competitions if any of the following apply:

  1. The Participant or any member of their household is exhibiting one symptom(s) of COVID-19 that first appeared within the last 10 days: fever (at or over 100.4°F or 38°C) or chills, cough, shortness of breath or difficulty breathing, feeling tired, muscle or body aches, headache, sore throat, nausea or vomiting, diarrhea, congestion or runny nose, or new loss of taste or smell. The Participant or Parent/Guardian, if the Participant is a minor, will check Participant’s temperature at home prior to attending meetings, practices, and/or competitions; and Participant will not attend if their temperature is at or over 100.4°F or 38°C.
  2. The Participant or any member of their household has been diagnosed with COVID-19 or has a suspected diagnosis of COVID-19 or pending COVID-19 test.
  3. The Participant or any member of their household has spent time with another individual who has been diagnosed with COVID-19 or has a suspected diagnosis of COVID-19.

The Participant or any member of their household is currently under isolation or quarantine orders.

Participant Initial:

● If the Participant tests positive for COVID-19 or has been identified as being exposed to an individual
that has tested positive for COVID-19, the participant agrees to immediately inform West Los Angeles Obedience Training Club (WLAOTC) and acknowledges that WLAOTC must contact the Los Angeles County Department of Public Health (LACDPH) to provide information regarding the confirmed positive test, including Participant’s name and contact information. I consent to WLAOTC providing such information to LACDPH or any other the administrative body as required by law. I agree to willingly cooperate with any contact tracing that is deemed necessary by the WLAOTC and / or LACDPH.

Participant Initial:

● I am aware that the I may be exposed to COVID-19 while participating in or attending meetings, practices and/or competitions. I understand that this exposure carries a risk of infection, serious illness, or death for both the participant and their household members.

Participant Initial:
● I acknowledge WLAOTC, the Governor, State Department of Health, LACDPH, or other administrative body with authority over WLAOTC may determine to cancel a class or the season at any time. I also acknowledge WLAOTC must comply with any mandates issued by any entity with the authority over athletics and agree to comply with any such directives even if issued after signature to this agreement.

Participant Initial:

● Participant is aware that classes, spectating, and/or transportation will look different than prior years,
including the need for physical distancing and the correct and consistent use of face masks. I agree to comply with the direction provided by the instructors and acknowledge that the failure to do so may result in the Participant being refused participation in the program.

Participant Initial:
● Participant is voluntarily participating in classes. Participant agrees to assume any and all risks of infection, injury, or death, whether those risks are known or unknown.

Participant Initial:

I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE OF THE RISKS OF PARTICIPATING IN ATHLETICS DURING THE COVID-19 PANDEMIC. I AM AWARE THAT THIS FORM CONTAINS A RELEASE OF LIABILITY AND WAIVER OF ALL CLAIMS. I AM SIGNING THIS AGREEMENT VOLUNTARILY, FULLY AWARE OF THE RISKS AND MY RELEASE AND WAIVER OF ANY CLAIM AGAINST WLAOTC,ITS EMPLOYEES, AGENTS, BUSINESS MANAGER, BOARD MEMBERS, OR OTHER RELATED ENTITIES.

Participant's name:
* First Name: 
* Last Name: 

Participant's signature:___________________________________________________________________________________

* I accept the terms included above and by checking this box indicate my agreement to them and that this is a substitute for my signature. I understand without this acceptance I will be unable to attend classes offered by WLAOTC.

* Email:

 

At the bottom of the next page will be a link to the third waiver form.



WLAOTC Home | Site Map

Last Updated 04/23/2021

Photos copyrighted by owners 
Used with permission 
Background, original graphics, and original text 
Copyright@2000 - 2021 WLAOTC or their authors 
All Rights Reserved