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COVID-19 Safety and Risk Acknowledgement Form

Camp Bruce McCoy COVID-19 Policies & Procedures

The Brain Injury Association of Virginia (BIAV) and its associated programs, including Camp Bruce McCoy, will be adhering to the CDC guidelines and state restrictions regarding COVID-19 that are active during the time of camp. All Camp Bruce McCoy participants are required to be fully vaccinated for at least 30 days prior to the start of camp (May 22, 2022) to reduce the risks of COVID-19 exposure and transmission. This means a camp participant must receive the final dose of their primary COVID-19 vaccination series by May 8, 2022, which allows for the 14-day period before being considered fully vaccinated per the CDC’s definition. Please refer to the BIAV COVID-19 Precautions and Resource Guide for Camp Bruce McCoy 2022 included in the application packet – this includes a detailed breakdown of the CDC’s current guidelines regarding vaccinations, masks, testing, exposure, quarantine, and isolation. Please keep in mind the following guidelines are subject to change between the time you submit this form and the start of camp any relevant updates will be communicated via email, so please monitor your inbox regularly.    

Because certain strains of COVID-19 can be extremely contagious even among vaccinated individuals, BIAV is implementing several preventative measures to reduce the spread of COVID-19. However, BIAV cannot guarantee that its staff, volunteers, caregivers, or others in attendance will not become exposed to or infected with COVID-19. BIAV’s COVID-19 preventative measures for Camp Bruce McCoy 2022 include, but are not limited to the following:  

Note: We strongly reiterate the CDC’s recommendation that anyone who received J&J should get a Pfizer-BioNTech or Moderna booster shot at least 2 months after the single dose of J&J. 

           The preventative measures detailed above reflect the most current CDC Guidelines for COVID-19 Prevention. 

COVID-19 SAFETY AND RISK ACKNOWLEDGEMENT FORM 

Please carefully review the following content before signing the document. In light of the ongoing spread of COVID-19, this form must be signed by all attendees or their guardians. By signing and submitting this form before camp, the applicant and/or their guardian certifies that they will not report to Camp Bruce McCoy on the assigned day if the applicant falls into any of the following categories:  

CAMP BRUCE MCCOY WEEK 1  CAMP BRUCE MCCOY WEEK 2 
Dates: May 22-28  10-day period before: May 12-21  Dates: May 29-June 4  10-day period before: May 19-28 

It is the responsibility of all accepted campers, their families, and/or caregivers to self-monitor for signs and symptoms of COVID-19 within ten (10) days BEFORE and AFTER attending Camp Bruce McCoy. Please be mindful that any exposure to COVID-19 in the ten (10) days before camp would disqualify you from attending; as such, we strongly recommend campers take COVID-19 precautionary measures in the community (i.e., mask in public, avoid large gatherings) to prevent this situation. Should a camper fall into one of the above categories before reporting to camp and is unable to attend, our current refund policy will be applied. By signing this form, you agree to contact BIAV immediately if camp participants experience symptoms of COVID-19 either BEFORE or AFTER attending camp.   

I am fully aware that by May 6, 2022, I must submit proof that I have been fully vaccinated against COVID-19 for at least one full month before my camp arrival date in order to attend. I recognize that in order to attend camp, I will be required to adhere to any updates to BIAV’s COVID-19 Prevention Policies for Camp Bruce McCoy 2022, including the screening and testing policies – these updates will be communicated to accepted campers as they are made. BIAV will continue to monitor community transmission, accessibility to COVID-19 testing, and related CDC guidelines to inform any updates to our policies. I am also fully aware that participation in this camp carries with it certain inherent risks related to COVID-19 transmission that cannot be fully eliminated, regardless of the care taken to avoid such risks. Inherent risks may include, but are not limited to: (1) The risk of coming into close contact with individuals or objects that may be carrying COVID-19; (2) The risk of transmitting or contracting COVID-19, directly or indirectly, to or from other individuals; and (3) Injuries and/or complications resulting directly or indirectly from COVID-19 or the treatment thereof. I hereby voluntarily accept and assume all risks of loss, personal injury, sickness, damage and expense arising from such inherent risks.  

 

By signing below, I agree to comply with the written instructions above. My signature also indicates the assumption of risk as it relates to COVID-19. Failure to comply with the outlined precautions will result in my privileges being removed and I will be asked to leave the premises.  

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