NOTICE OF RISKS AND PROTOCOLS FOR CRITICAL SECTOR COURSE STUDENTS REGARDING COVID-19

Please read the following thoroughly. Where it says initial, please do so to acknowledge that you have read and agree to that section. This document releases the Siskiyou Joint Community College District, its officers, employees, agents and volunteers of any and all liability.

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* 1. I understand that by signing the acknowledge of receipt below, I agree that I understand the risks of exposure to the virus that causes COVID-19 via my Critical Sector courses at Siskiyou Joint Community College that I have determined to continue my course work, and thus agree to the following:

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* 2. I will minimize my social contact with others because of the potential risk of COVID-19 virus transmission.

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* 3. I understand that there may be risks that cannot be determined until we know more information about the virus that causes COVID-19 or the transmission of the virus that causes COVID-19.

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* 4. I will follow the CDC's procedures and College instructions to limit my exposure to, or transmission of, COVID-19 virus, including the following:

Follow proper hand-washing technique before and after all contact with all persons and associated equipment. Use an alcohol-based hand sanitizer when hand-washing is not readily available. 

Follow proper uses of Personal Protective Equipment. (PPE) including gloves and eye protection for all person/student/instructor contacts. Follow proper procedure use of face covering/Self-Contained Breathing Apparatus (SCBA)/turnout gear use for any potentially infectious situation or person as deemed necessary by college staff.

Follow any College or CDC physical distancing directives.

Follow all directives regarding ingress and egress from the College, and instructions regarding my use specific facilities and times limiting my house of those facilities.

Report any exposure I may have to COVID-19 to the Director of Facilities.

Report COVID-19 symptoms I experience within the designated self-monitoring application. 

Have my temperature taken and undergo a screening for COVID-19 symptoms before the start of any Critical Sector class session. 

Leave immediately if I have a fever or if I experience any symptoms of COVID-19.

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* 5. ACKNOWLEDGEMENT OF RECEIPT AND UNDERSTANDING OF NOTICE OF RISKS AND PROTOCOLS FOR CRITICAL SECTOR COURSES 

Typing my full name below indicates that I understand the risks associated with continuing the course and agree to take the precautions described above.

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* 6. I would like to receive a copy of my completed form.

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* 7. E-mail address

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* 8. S number

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* 9. What is your primary means of transportation?

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