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FEBRUARY 8, 2021


CLUB NAME: _Fox Lane Youth Lacrosse_________________     SPORT: __Lacrosse________


PARENT/GUARDIAN: _______________

The State of New York recently updated its “Interim COVID-19 Guidance for Sports and Recreation” permitting higher risk sports to participate in athletic competitions only if permitted by local health departments.  This Code of Conduct is intended to enable athletes and parents\guardians to acknowledge their personal responsibility in taking steps to protect themselves, their families, spectators and those involved with Recreational/Club athletics.

In order to reduce my risk of contracting COVID-19, I commit to reading the health risk communication and abiding by all existing guidelines both on and off the field to ensure the safety of my family, teammates, classmates, community and myself.  I commit to reviewing these guidelines and understand that my sports program may provide updates as additional information is available. It is my responsibility to stay apprised of these changes to protect myself and others. As a Westchester County student-athlete, I pledge to:

 _GW (initial) participate in all required daily assessments and self-assessments of COVID-19 exposure and symptoms;

GW (initial) follow all social distancing guidelines, including the wearing of masks or appropriate face coverings;

_GW (initial) not participate in social gatherings, parties or other activities which are known to increase the potential spread of COVID-19;

_GW(initial) submit to COVID-19 testing any time it is required, and abide by any and all County health department isolation or quarantine orders as I am directed by my school, my athletic club or health care providers; and

_GW (initial) not participate in recreational\club athletics, school classes or athletic events or practices if I am feeling ill or if I have any of the following symptoms, until cleared to return to practice by a health care professional including but not limited to:  Fatigue/feeling of tiredness; headaches; muscle pain or body aches; a temperature greater than or equal to 100.0° F (37.8° C); feel feverish/have chills, cough; nasal congestion / runny nose, loss of taste or smell; sore throat, nausea, vomiting, diarrhea, shortness of breath or trouble breathing.


By signing below, I acknowledge that I have read, understand and will abide by this Code of Conduct Relating to Recreational/Club Athletics.  I recognize that COVID-19 is a highly contagious virus and it is possible to develop and contract the COVID-19 disease even if I follow all of the safety recommendations and comply with the pledge.  I further understand that even though the program is following the guidelines issued by the CDC and other experts to reduce the spread of infection, a COVID-19 free environment can never be guaranteed.


I understand that if I do not honor my pledge, I may be failing to comply with a legitimate program directive and pursuant to the program’s rules or standards, I therefore may be subject to the appropriate accountability measures and disciplinary actions.  I also understand that I have chosen to participate in a high-risk activity during a pandemic, and have voluntarily assumed the risk of contracting COVID-19.


Student Name/Signature:________________

By my/our signature below, we acknowledge the information provided is accurate, and will immediately advise the school if our student athlete does or has ever tested positive for COVID-19.


Parent/Guardian Name/Signature:______________