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Altus Mountain Guides Ltd. takes the safety of their guests and employees, and the prevention of the spread of the COVID-19 pandemic very seriously. As such, you are required to make four attestations below.

The inability to make one or more of these attestations may disqualify you from participation.

 

I, the undersigned, attest to the following: (please sign each applicable attestation)

1) To the best of my knowledge, I do not have the novel coronavirus COVID-19 or any variant of thenovel coronavirus COVID-19, nor have I had it within the past 14 days

2) To the best of my knowledge, I have not been exposed to someone who has the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19 within the past 14 days

3) Within the past 14 days, I have not experienced any of the following that are new and not related to allergies or pre-existing conditions: persistent cough, fever higher than 38 degrees Celsius (98.6 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose

4) I have not travelled outside Canada during the past 14 days

By signing below, I confirm my understanding that I may be refused participation in, or be asked to leave, this trip/course, with no option for refund of payment, if any of the above attestations are found to be incorrect or if the status of those attestations changes between the time of signing of this form and any time before the end of the trip/course.

Name of participant (please print) Signature of participant

April 16, 2024

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
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Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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