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Kingston Elite Declaration of Compliance- COVID-19

WARNING!

ALL INDIVIDUALS ENTERING THE FACILITY AND/OR PARTICIPATING IN SANCTIONED ACTIVITIES MUST COMPLY WITH THE DECLARATION

The Ontario Cheerleading Federation and its registered and member clubs (collectively Kingston Elite All-Star Cheerleading Inc.) require the disclosure of exposure or illness is in order to safeguard the health and safety of all participants and limit the further spread of COVID-19. This Declaration of Compliance will be kept safely, and personal information will not be disclosed unless as required by law or with your consent. 

An individual (or the individual's parent/guardian, if the individual is younger than 18 years old) who is unable to agree to the terms outlined in this document is not permitted to enter Kingston Elite All-Star Cheerleading's Inc. facility or participate in Kingston Elite All-Star Cheerleading's activities, programs, or services. 

I, the undersigned being the individual named above and the individual's parent/guardian (if the individual is younger than 18 years old), hereby acknowledge and agree to the terms outlined in this document:

  1. The coronavirus disease COVID-19 has been declared a worldwide pandemic by the World Health Organization and COVID-19 is extremely contagious. Kingston Elite All-Star Cheerleading Inc. has put in place preventative measures to reduce the spread of COVID-19 and requires all individuals (or their parent/guardian, when applicable) to adhere to the compliance standards set out by Kingston Elite All-Star Cheerleading Inc. 
  2. The individual has not been diagnosed with COVID-19, OR if the individual was diagnosed with COVID-19, the individual was cleared as noncontagious by provincial or local public health authorities. 
  3. If the individual is a front-line worker (such as hospital staff, long term care staff, or other individual who interacts with individuals who have confirmed or suspected cases of COVID-19) or travels outside of Canada, the individual has worn proper and approved Personal Protective Equipment at all times whenever they interacted with an individual who has a confirmed or suspected case of COVID-19 in the last 14 days. 
  4. If the individual is not a front-line worker, and to their best knowledge, they have not been exposed to a person with a confirmed or suspected case of COVID-19 in the last 14 days.
  5. The individual is attending or participating voluntarily and understands the risks associated with COVID-19. The individual (or the individual's parent/guardian, on behalf of the individual) agrees to assume those risks, including but not limited to exposure and being infected.
  6. The individual has not, nor has anyone in the individual's household, experienced any signs or symptoms of COVID-19 in the last 14 days (including fever, new or worsening cough, fatigue, chills and body aches, respiratory illness, difficulty breathing, nausea, vomiting or loss of taste or smell). 
  7. If the individual experiences, or if anyone in the individual's household experiences, new or worsening symptoms of COVID-19 that are unrelated to a known or pre-existing condition after submitting this Declaration of Compliance, the individual will notify Kingston Elite All-Star Cheerleading Inc., and get tested as soon as possible. If a positive test is received, the individual will not attend Kingston Elite All-Star Cheerleading's Inc. facility, activities, programs or services until at least 14 days have passed since those symptoms were last experienced. If a negative test is received, the individual will provide a copy of this negative test to Kingston Elite All-Star Cheerleading Inc. if possible. 
  8. The individual is following recommended guidelines, including but not limited to, practicing physical distancing, trying to maintain separation of 2 meters from others, adhering to recognized hygiene best practices, and otherwise limiting exposure to COVID-19. 
  9. The individual will follow the safety, physical distancing and hygiene protocols of Kingston Elite All-Star Cheerleading Inc.
  10. This document will remain in effect until Kingston Elite All-Star Cheerleading Inc., per the direction of the municipal, provincial, and federal governments and provincial health officials, determines that the acknowledgements in this Declaration of Compliance are no longer required.
  11. Kingston Elite All-Star Cheerleading Inc. may remove the individual from the facility or from participation in the activities, programs or services of Kingston Elite All-Star Cheerleading Inc. at any time and for any reason if Kingston Elite All-Star Cheerleading Inc. believes, in its sole discretion, that the individual is no longer in compliance with any of the standards described in this document.
First Athlete's Name

First Name*

Middle Name

Last Name*

Phone*
First Athlete's Date of Birth*
First Athlete's Information

Individual's Parent/Guardian (if the individual is younger than 18 years old) *
First Athlete's Signature*
Second Athlete's Name

First Name*

Middle Name

Last Name*
Second Athlete's Date of Birth*
Second Athlete's Information

Individual's Parent/Guardian (if the individual is younger than 18 years old) *
Third Athlete's Name

First Name*

Middle Name

Last Name*
Third Athlete's Date of Birth*
Third Athlete's Information

Individual's Parent/Guardian (if the individual is younger than 18 years old) *
Fourth Athlete's Name

First Name*

Middle Name

Last Name*
Fourth Athlete's Date of Birth*
Fourth Athlete's Information

Individual's Parent/Guardian (if the individual is younger than 18 years old) *
Fifth Athlete's Name

First Name*

Middle Name

Last Name*
Fifth Athlete's Date of Birth*
Fifth Athlete's Information

Individual's Parent/Guardian (if the individual is younger than 18 years old) *
Sixth Athlete's Name

First Name*

Middle Name

Last Name*
Sixth Athlete's Date of Birth*
Sixth Athlete's Information

Individual's Parent/Guardian (if the individual is younger than 18 years old) *
Seventh Athlete's Name

First Name*

Middle Name

Last Name*
Seventh Athlete's Date of Birth*
Seventh Athlete's Information

Individual's Parent/Guardian (if the individual is younger than 18 years old) *
Eighth Athlete's Name

First Name*

Middle Name

Last Name*
Eighth Athlete's Date of Birth*
Eighth Athlete's Information

Individual's Parent/Guardian (if the individual is younger than 18 years old) *
Ninth Athlete's Name

First Name*

Middle Name

Last Name*
Ninth Athlete's Date of Birth*
Ninth Athlete's Information

Individual's Parent/Guardian (if the individual is younger than 18 years old) *
Tenth Athlete's Name

First Name*

Middle Name

Last Name*
Tenth Athlete's Date of Birth*
Tenth Athlete's Information

Individual's Parent/Guardian (if the individual is younger than 18 years old) *
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.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Individual's Parent/Guardian (if the individual is younger than 18 years old) *
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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