Azura Virtual Training Waiver Azura Virtual Training Waiver Participant's Name* First Last Parent or Guardian's Name (only if participant is under 18 years old)* First Last Participant's Date of Birth* Date Format: MM slash DD slash YYYY Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Participant or Parent/Guardian's Phone*Participant's Email* Enter Email Confirm Email Participant Parent/Guardian's Email* Enter Email Confirm Email Azura Photography Consent* I agree to the photography consent policy.I grant permission to Azura Florida Aquatics and Azura Virtual Training (AVT) and its agents and employees the irrevocable and unrestricted right to reproduce the photographs and/or video images taken of me, or members of my family, for the purpose of publication, promotion, illustration, advertising, or trade, in any manner or in any medium. I hereby release Azura Florida Aquatics and its legal representatives for all claims and liability relating to said images or video. Furthermore, I grant permission to use my statements that were given during an interview or guest lecture, with or without my name, for the purpose of advertising and publicity without restriction. I waive my right to any compensation. Azura Hold Harmless Waiver* I agree to the Azura Hold Harmless Waiver.It is my intent as a participant of Azura Virtual and/or Azura Florida Aquatics (Team Davie Inc.) activities, while participating during activities including any pre and post workout that I am agreeable to the following: I acknowledge that I am aware that there are risks to me of exposure to directly or indirectly arising out of, contributed to, by, or resulting from: • An outbreak of any and all communicable disease, including but not limited to, the virus “severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)”, which is responsible for Coronavirus Disease (COVID-19) and/or any mutation or variation thereof; In consideration of having the opportunity to participate as either a team member, and in acknowledging that I am aware of and willing to assume the risks associated with this activity, I hereby voluntarily agree to waive, hold harmless and indemnify Azura Florida Aquatics (Team Davie Inc.) and its trustees, agents, volunteers and employees from any and all claims, demands, damages and causes of action of any nature whatsoever arising out of ordinary negligence which I, my heirs, my assigns or successors may have against them for, on account of, or by reason of my participation in the above activities. I indicate my agreement to this hold harmless elective noted below. Azura Virtual Training Waiver* I agree to the AVT waiver policy.In order for me to be able to participate in the Azura Virtual Training Program (AVT), I understand that I must read and agree to assume ALL the risks for participation, agree to this waiver of liability, and adhere to all AVT training policies and procedures. I understand that the program is voluntary and that AVT will develop and guide me through my exercise program(s) on-land and in-water. I understand that the online exercise guides are designed for those individuals who do not have certain medical limitations regarding exercise. If applicable, I will accurately and completely disclose any prescribed medications that I am taking as well as any exercise limitations that I am aware of or have been informed of by my doctor, so that AVT can develop a modified plan with my personal medical considerations in mind. Throughout the duration of the program should my medications, condition, or medical limitations change, I will notify AVT. I understand that it is recommended that I have a yearly physical or more frequent physical examination and consultation with my doctor, so that I am aware of what is appropriate for me with regards to physical activity. I acknowledge that I have either had a recent physical exam and have been given my physician’s permission to participate or that I have decided to participate without the approval of my physician. I understand that while AVT will review any disclosed medical limitations, AVT is not a physician and cannot replace the advice and expertise of a physician. I understand that I have the complete right to stop or decrease exercise at any time during a session, and that it is my obligation to notify my physician or seek medical attention immediately if I develop any symptoms such as fatigue, shortness of breath or chest discomfort. I realize that participation in the program included, but is not limited to exercising, use of exercise equipment and strenuous exertion (strength training) all of which increase heart rate and body temperature. I understand that exercise involves certain risks, including but not limited to, serious neck and spinal injuries resulting in complete or partial paralysis, heart attack, stroke or even death. Also, injuries could occur to bones, joints or muscles. Slips, falls, and unintended loss of balance could result in muscular, neurological, orthopedic or other bodily injury. I understand that part of the risk involved in undertaking any activity or program is relative to my own state of fitness or health (physical, mental, or emotional) and to the awareness, care and skill in which I conduct myself in that activity or program. Knowing the material risks and appreciating, knowing and reasonably anticipating that other injuries are a possibility, I hereby expressly assume all of the delineated risks of injury, all other possible risks of injury, and even risk of possible death, which could occur by reason of my participation. I do hereby waive, release and forever discharge Azura Florida Aquatics and Azura Virtual Training (Team Davie Inc.) from any and all responsibilities or liability for any present or future injuries or damages resulting or arising from my participation in any activities including but not limited to use of exercise on-land and in-water, personal training or use of the equipment including any injuries and damages caused by the negligent act or omission of any of those persons or entities mentioned above. AZURA MAAP Policy* I agree to the AZURA MAAP policy.THIS POLICY APPLIES TO: • All USA Swimming non-athlete members and adult athlete members; • Participating non-members (e.g., meet marshals, meet computer operators, timers, etc.); • LSC and club adult staff and board members; and • Any other adult authorized to have regular contact with or authority over minor athletes. GENERAL REQUIREMENT USA Swimming member clubs and LSCs are required to implement this Minor Athlete Abuse Prevention Policy in full. The Minor Athlete Abuse Prevention Policy must be reviewed and agreed to in writing by all athletes, parents, coaches and other non-athlete members of member clubs on an annual basis with such written agreement to be retained by the club. ONE-ON-ONE INTERACTIONS I. Observable and Interruptible One-on-one interactions between a minor athlete and an Applicable Adult (who is not the minor’s legal guardian) must occur at an observable and interruptible distance from another adult unless meeting with a Mental Health Care Professional and/or Health Care Provider (see below) or under emergency circumstances. II. Meetings a. Meetings between a minor athlete and an Applicable Adult may only occur if another adult is present and where interactions can be easily observed and at an interruptible distance from another adult, except under emergency circumstances. b. If a one-on-one meeting takes place, the door to the room must remain unlocked and open. If available, it must occur in a room that has windows, with the windows, blinds, and/or curtains remaining open during the meeting. c. Meetings must not be conducted in an Applicable Adult or athlete’s hotel room or other overnight lodging location during team travel. III. Meetings with Mental Health Care Professionals and/or Health Care Providers If a Mental Health Care Professional and/or Health Care Provider meets with a minor athlete in conjunction with participation, including at practice or competition sites, a closed-door meeting may be permitted to protect patient privacy provided that: a. The door remains unlocked; b. Another adult is present at the facility; c. The other adult is advised that a closed-door meeting is occurring; and d. Written legal guardian consent is obtained in advance by the Mental Health Care Professional and/or Health Care Provider, with a copy provided to the Azura Florida Aquatics IV. Individual Training Sessions [Recommended] Individual training sessions outside of the regular course of training and practice between Applicable Adults and minor athletes are permitted if the training session is observable and interruptible by another adult. Legal guardians must be allowed to observe the training session. SOCIAL MEDIA AND ELECTRONIC COMMUNICATIONS I. Content All electronic communication from Applicable Adults to minor athletes must be professional in nature. II. Open and Transparent Absent emergency circumstances, if an Applicable Adult with authority over minor athletes needs to communicate directly with a minor athlete via electronic communications (including social media), the minor athlete’s legal guardian must be copied. If a minor athlete communicates to the Applicable Adult (with authority over the minor athlete) privately first, said Applicable Adult mustcopy the minor athlete’s legal guardian on any electronic communication response to the minor athlete. When an Applicable Adult with authority over minor athletes communicates electronically to the entire team, said Applicable Adult must copy another adult. III. Requests to Discontinue Legal guardians may request in writing that their minor athlete not be contacted through any form of electronic communication by Azura Florida Aquatics, LSC or by an Applicable Adult subject to this Policy. The organization must abide by any such request that the minor athlete not be contacted via electronic communication, or included in any social media post, absent emergency circumstances. IV. Hours Electronic communications must only be sent between the hours of 8:00 a.m. and 8:00 p.m., unless emergency circumstances exist, or during competition travel. V. Prohibited Electronic Communication Applicable Adults with authority over minor athletes are not permitted to maintain private social media connections with unrelated minor athletes and such Applicable Adults are not permitted to accept new personal page requests on social media platforms from minor athletes, unless the Applicable Adult has a fan page, or the contact is deemed as celebrity contact as opposed to regular contact. Existing social media connections with minor athletes must be discontinued. Minor athletes may “friend” Azura Florida Aquatics and/or LSC’s official page. Applicable Adults with authority over minor athletes must not send private, instant or direct messages to a minor athlete through social media platforms. TRAVEL I. Local Travel Local travel consists of travel to training, practice and competition that occurs locally and does not include coordinated overnight stay(s). Applicable Adults must not ride in a vehicle alone with an unrelated minor athlete, absent emergency circumstances, and must always have at least two minor athletes or another adult in the vehicle, unless otherwise agreed to in writing by the minor athlete’s legal guardian. [Recommended] Legal guardians must pick up their minor athlete first and drop off their minor athlete last in any shared or carpool travel arrangement. II. Team Travel Team travel is travel to a competition or other team activity that the organization plans and supervises. a. During team travel, when doing room checks two-deep leadership (two Applicable Adults should be present) and observable and interruptible environments must be maintained. When only one Applicable Adult and one minor athlete travel to a competition, the minor athlete’s legal guardian must provide written permission in advance and for each competition for the minor athlete to travel alone with said Applicable Adult. Team Managers and Chaperones who travel with Azura Florida Aquatics or LSC must be USA Swimming members in good standing. b. Unrelated Applicable Adults must not share a hotel room, other sleeping arrangement or overnight lodging location with a minor athlete. Minor athletes should be paired to share hotel rooms or other sleeping arrangements with other minor athletes of the same gender and of similar age. c. Meetings during team travel must be conducted consistent with the One-on-One Interactions section of this Policy (i.e., any such meeting must be observable and interruptible). Meetings must not be conducted in an individual’s hotel room or other overnight sleeping location. LOCKER ROOMS AND CHANGING AREAS I. Requirement to Use Locker Room or Changing Area The designated locker room or changing area must be used when an athlete or Applicable Adult changes, in whole or in part, into or out of a swimsuit when wearing just one suit (e.g., deck changing is prohibited). II. Use of Recording Devices Use of any device’s (including a cell phone’s) recording capabilities, including voice recording, still cameras and video cameras in locker rooms, changing areas, or similar spaces by a minor athlete or an Applicable Adult is prohibited. III. Undress An unrelated Applicable Adult must not expose his or her breasts, buttocks, groin or genitals to a minor athlete under any circumstance. An unrelated Applicable Adult must not request an unrelated minor athlete to expose the minor athlete’s breasts, buttocks, groin or genitals to the unrelated Applicable Adult under any circumstance. IV. One-on-One Interactions Except for athletes on the same team or athletes attending the same competition, at no time are unrelated Applicable Adults permitted to be alone with a minor athlete in a locker room or changing area, except under emergency circumstances. If the organization is using a facility that only has a single locker room or changing area, separate times for use by Applicable Adults must be designated. V. Monitoring Azura Florida Aquatics must regularly and randomly monitor the use of locker rooms and changing areas to ensure compliance with this Policy. Locker rooms and changing areas may be monitored by use of the following methods: a. Conducting a sweep of the locker room or changing area before athletes arrive; b. Posting staff directly outside the locker room or changing area during periods of use; c. Leaving the doors open when adequate privacy is still possible; and/or d. Making occasional sweeps of the locker rooms or changing areas with women checking on female locker rooms and men checking on male locker rooms. Every effort must be made to recognize when a minor athlete goes to the locker room or changing area during practice and competition, and, if the minor athlete does not return in a timely fashion, to check on the minor athlete’s whereabouts. VI. Legal Guardians in Locker Rooms or Changing Areas Legal guardians are discouraged from entering locker rooms and changing areas. If a legal guardian does enter a locker room or changing area, it must only be a same-sex legal guardian and the legal guardian should notify a coach or administrator in advance. MASSAGES AND RUBDOWNS/ATHLETE TRAINING MODALITIES I. Definition: In this section, the term “Massage” refers to any massage, rubdown, athletic training modality including physical modalities (e.g., stretching, physical manipulation, injury rehabilitation, etc.) and electronic or instrument assisted modalities (e.g., stim treatment, dry needling, cupping, etc.). Adopted: June 23, 2019 Last reviewed on: June 18, 2019 II. General Requirement Any Massage performed on an athlete must be conducted in an open and interruptible location and must be performed by a licensed massage therapist or other certified professional. However, even if a coach is a licensed massage therapist, the coach must not perform a rubdown or massage of an athlete under any circumstance. III. Additional Minor Athlete Requirements a. Written consent by a legal guardian must be obtained in advance by the licensed massage therapist or other certified professional, with a copy provided to Azura Florida Aquatics. b. Legal guardians must be allowed to observe the Massage. c. Any Massage of a minor athlete must be done with at least one other adult present and must never be done with only the minor athlete and the person performing the Massage in the room. d. Any Massage of a minor athlete must only occur after a proper diagnosis from a treating physician and be done in the course of care according to the physician’s treatment plan.NameThis field is for validation purposes and should be left unchanged.