COVID Vaccine Declaration and Test Waiver

Required

There are two sections to this form, the Vaccine Status Declaration and the Testing Waiver. Both sections must be completed for ALL students. 

VACCINE STATUS DECLARATION

Vaccination is currently the leading public health prevention strategy to end the COVID-19 pandemic. SAS encourages all students eligible for the vaccine to be fully vaccinated before school starts. Students who become eligible during the school year should receive their vaccinations as soon as they are able. International students who do not have access to the vaccine in their home country will be provided with the opportunity to be vaccinated upon arrival.

To help us to implement appropriate protocols and precautions, please complete the following.

Student's Namerequired
First Name
Last Name
Has your child been vaccinated for COVID-19?
Please provide a copy of your child's COVID-19 vaccination card to our Health Clinic by uploading the information to MAGNUS as part of their vaccine record, emailing a copy to nurses@sasweb.org, or faxing a copy to 931.914.1224. Your failure to provide proof of vaccination may result in your child being tested periodically at your expense ($60/test).
As recommended by the CDC, all SAS students should wear a face covering indoors, on school vans and buses, and when physical distancing is not possible. 
 
ALL students must provide proof of vaccine OR a negative COVID PCR test taken within 72 hours prior to their return to campus (whether that is for athletic practice, move-in, Proctor training, or orientation).

ACKNOWLEDGEMENT OF REQUIRED TESTING, CONTACT TRACING, AND RELEASE OF INFORMATION

Reason for Non-Vaccinated Status and COVID Testing Release

All students must have a completed testing waiver regardless of vaccine status.

As the parent of a student at St. Andrew’s-Sewanee School, I understand that the School has developed health and safety rules and protocols, in accordance with guidance and recommendations of the Centers for Disease Control, the Tennessee Department of Health, and other state and federal agencies. Specifically, I understand:

  • My child may not attend classes in person or engage in other activities on campus if they have tested positive for COVID-19 or have been exposed to a person who has tested positive for COVID-19 until they have completed a period of isolation or quarantine and been approved to return to in-person activities.
  • The School requires that all students participate in surveillance testing for COVID-19 when requested.  
  • That refusal to participate in such testing may result in a decision that my child must leave campus. If my child has a valid medical necessity not to participate in the testing and screening protocols, I will request an accommodation from the Director of the Health Clinic, and the School will attempt to find a reasonable accommodation.
  • The School understands that the information to be provided in carrying out the health and safety protocols is confidential and private information. Such information will be maintained only to the extent necessary to monitor conditions on campus related to COVID-19.
  • I understand that if my child’s test sample is positive, additional testing may be necessary by my family physician or other healthcare provider.
  • I will be notified of a positive outcome of any COVID-19 test my child takes at the School by receiving a phone call from the Director of the Health Clinic.
  • If I receive notice of a positive COVID-19 test result, my child will be required to complete a period of isolation in accordance with School’s COVID-19 policies. My child will not be allowed to return to in-person activities on campus until my child has completed the required period of isolation and has been approved to return to in-person activities by the School.
  • My child’s test results and contact information will be provided to the applicable Tennessee State and County Departments of Health as required by law for the purpose of contact tracing. In addition, if my student is taking courses at the University of the South, my child's test results and contact information may be provided to the University.
  • During the contact tracing process, I am aware that my child’s test result information will be provided to School officials who have been trained on issues of confidentiality and conducting contact tracing so that they may (1) contact other School community members with whom my child had contact in accordance with contact tracing protocols and (2) contact other School officials with a need to know, including: my child’s academic advisor; my child’s current teachers and/or coaches; the Dean of Students; and the Academic Dean.
By checking the box below, I certify that I am the legal guardian of the student listed here, I have read the above document, agree to the terms, and give permission for my child to be tested. 

I further understand the following:

  1. I do not have to sign this authorization, but my refusal may affect my child’s ability to continue to live in School housing and/or to participate in campus instruction and/or activities.
  2. I may cancel this authorization at any time by submitting a written request to the Director of the Health Clinic. This cancellation will not be applicable to any disclosures already made prior to consent.
  3. The information released will be limited to that which is necessary to fulfill the purpose of the disclosure.
  4. I freely give this consent and I do hereby release and hold harmless the School from any and all liability or damage which may result from the disclosure of information herein authorized.
Acknowledgement, Waive and Release