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Informed Consent - Families


A school is a community. During this public health emergency, EACH member of our community needs to help keep COVID-19 out of our school. Exposures can lead to the closure of the entire school and impact all the families we are serving. We appreciate your partnership and commitment in this collective effort. If you have any questions about this form, please email or call 425-372-2800
Must contain a date in M/D/YYYY format

1. Partnership
I understand that I play a crucial role in keeping everyone in our community safe and reducing the risk of exposure by following the policies and practices outlined in this Informed Consent and Acknowledgment. I acknowledge that I may be denied access to the school for my failure or refusal to act in accordance with these provisions at all times, in a respectful and appropriate way.

2. COVID-19 Exclusion Policy and Health Check and Illness Policy-COVID-19
I have reviewed and am familiar with Bright Horizons COVID-19 Policy and Bright Horizons Health Check and Illness Policy – COVID-19. I agree to comply with these policies, as they may be updated or amended from time to time. Complete copies of these policies are available to me here.

3. Reporting Confirmed Cases of COVID-19
I will immediately notify school administration if anyone in my household or any close contact of my household tests positive for COVID-19.

4. Exposure to COVID-19
I understand that to enter the center my ENTIRE household must be free from any known or suspected exposure to COVID-19. If my household has any known or suspected exposure to COVID-19, I understand I may be required to remain out of the school for at least 10 days, until all criteria to return are successfully met. I acknowledge that known/suspected exposures include (but are not limited to):

  • A member of my household having a confirmed case of COVID-19
  • A member of my household being tested or advised to be tested due to a known/suspected exposure to COVID-19
  • A member of my household being directed to quarantine or self-isolate
  • A member of my household having “close contact” with persons with known or suspected exposure to COVID-19

5. Negative Tests after Exposure
I understand that in the case of any known/suspected exposure, a subsequent negative test result will NOT reduce the time the household is required to remain out of the center. With respect to exposure due to travel, only the traveler will be excluded. In the case of domestic travel, the traveler may be eligible to return sooner if permitted in accordance with requirements of applicable local regulation, which requirements may include a negative test.

6. COVID-19 Symptoms
I understand that for me to enter the school my ENTIRE household must be free from the COVID-19 symptoms listed below. If COVID-19 symptoms are present in my household, I understand I will be required to remain out of the center for at least 10 days. I understand this list of COVID-19 symptoms may be updated and that additional symptoms may be included by local authorities under applicable local regulation. *Threshold may differ in certain localities

  • Cough
  • Muscle aches
  • Sore throat
  • Fever* of 100.4° or higher
  • Difficulty breathing
  • New loss of taste or smell

7. Clearance to Return- Symptoms
If I have been excluded from the school due to the presence of COVID-19 symptoms, I understand, under limited circumstances, I may be able to return to the school earlier if I can provide acceptable Clearance to Return from a medical provider (M.D., D.O., N.P., and P.A.) and the earlier return is permitted under any applicable local regulation. Clearance to Return will be acceptable if a medical provider assesses the symptomatic individual and provides written confirmation:

  • there is an alternate diagnosis causing the COVID-like symptoms, or
  • the symptomatic individual has tested negative, has been fever-free for at least 24 hours (without the use of fever-reducing medicines) and symptoms are resolving.

For clarity, an upper respiratory infection is not considered an acceptable alternate diagnosis and any unspecified diagnosis is presumed to be COVID. Clearance to Return must be provided by a third party and cannot be provided by a family member. Any exclusion for an exposure cannot be cleared by a medical provider. Any return to the school would remain subject to the requirements of the school's standard illness policy and compliance with the daily health screen requirements.

8. Daily Health Screen
I understand health screens will be conducted daily, either via a designated application or upon arrival. I will answer all health screen questions truthfully for myself and for every other person in my household. I understand that a temperature check will be taken on arriving at school.

9. Compliance
I will comply with all applicable legal requirements imposed, from time to time, on participants in school programs.

10. Acknowledgment
I understand that I will be in contact with children, families, and staff who may also be at risk for community exposure. I understand that no restrictions, guidelines, or practices will remove all risk of exposure to COVID-19 as the virus can be transmitted by persons who are asymptomatic and before some people show signs of infection. I agree to use my judgment about what is best for my family and household, including undertaking additional precautions to protect the health of those in my household that may be at increased risk for severe illness from COVID-19.

By typing my name in this box I acknowledge I have read, understood and agree on behalf of all members of my household and all individuals authorized to pick-up my child to the conditions noted above.

Must contain a date in M/D/YYYY format