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Sender One Covid-19 Policy Acknowledgment

Covid-19 Policy and Protocols
Participant understands the following as prerequisites and requirements for being on-site at a Sender One facility:

1. Participation Agreement and Covid-19 Policy Acknowledgment both must be reviewed and signed by all guests.
2. All guests must undergo a health screening prior to entry to a Sender One facility.

  • Health and contact questionnaire (verbal or written, at Sender One's discretion)
  • Body temperature check

3. Accept the conclusions and decisions reached; and follow the instructions given by Sender One staff and management for entry to a facility based on the health screening.

4. Use the Check-In and Check-Out stations, or if necessary, at the front desk, to log your presence in and out of your session (if reserved) and the facility.

5. Comply with Sender One's hygiene protocols (which may be amended as the Covid-19 pandemic evolves) while on-site, including, but not limited to, the following:

  • Maintaining a minimum distance of six (6) feet from other individuals.
  • Properly wearing (over nose and mouth) a face covering when, where, and how Sender One instructs and requires.
  • Comply with signage posted throughout the facility, which includes closures of certain areas of the facility.
  • Frequently wash hands (soap and water; or hand sanitizer)
  • Using liquid chalk prior to touching climbing holds and climbing walls.
  • Cleaning surfaces and common equipment after you use it.

6. Accept the conclusions and decisions reached; and follow the instructions given by Sender One staff and management for remaining at a facility based on the ability to comply with health and hygiene protocols.

7. Understand and comply to the best of your ability with the following recommendations:

  • Arrive at a facility already dressed appropriately for physical activity.
  • Minimize the amount of belongings you bring with you into a facility.
  • Keep your belongings in a single location within a facility.
  • If you can, come to a facility when it is less busy.

8. Agree to contact tracing and communications Sender One may undertake in light of contact tracing, particularly in accordance with local public health officials, guidance, and mandates.

My signature below indicates that I understand the information above and agree to comply with them to the best of my ability.

I Agree

Date: May 18, 2021

First Participant's Name

First Name*

Middle Name

Last Name*
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 Participant's Email Address

Email*

Confirm Email*
I represent that I am the parent or legal guardian of the minor participant(s) under the age of 14 listed above. I agree that the minor(s) have been made aware of the contents of the orientation form and it is both their and my responsibility that the minor(s) abide by this form's contents.
Parent or Guardian Participant's Name

First Name*

Middle Name

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