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DECLARATION OF COMPLIANCE – COVID-19

WARNING!
ALL PARTICIPANTS ENTERING THE FACILITY AND/OR PARTICIPATING IN SANCTIONED ACTIVITIES MUST EXECUTE AND COMPLY WITH THIS DECLARATION

Curling Canada, Curl ON and the High Park Club (collectively the “Organization”) require the disclosure of exposure of illness in order to safeguard the health and safety of all participants and limit the further outbreak 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.

A Participant (or the Participant’s parent/guardian, if the Participant is younger than the age of majority) who is unable to agree to the terms outlined in this document is not permitted to enter the Organization’s facilities or participate in the Organization’s activities, programs, or services.

I, the undersigned being the Participant named above and the Participant’s parent/guardian (if the Participant is younger than the age of majority), hereby acknowledge and agree to the terms outlined in this document:

  1. The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization and COVID-19 is extremely contagious. The Organization has put in place preventative measures to reduce the spread of COVID-19 and requires all Participants (or their parent/guardian, when applicable) to adhere to the compliance standards described in this document.
  2. The Participant has not been diagnosed with COVID-19; OR If the Participant was diagnosed with COVID-19, the Participant was cleared as non-contagious by provincial or local public health authorities more than 14 days prior to the date this Declaration of Compliance was signed.
  3. The Participant has not been exposed to a person with a confirmed or suspected case of COVID-19; OR If the Participant was exposed to a person with a confirmed case of COVID-19, the date of exposure was more than 14 days prior to the date this Declaration of Compliance was signed.
  4. The Participant is attending or participating voluntarily and understands the risks associated with COVID-19. The Participant (or the Participant’s parent/guardian, on behalf of the Participant, when applicable) agrees to assume those risks, including but not limited to exposure and being infected.
  5. The Participant has not, nor has anyone in the Participant’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 diarrhea, pink eye, or loss of taste or smell).
  6. If the Participant experiences, or if anyone in the Participant’s household experiences, any signs or symptoms of COVID-19 after submitting this Declaration of Compliance, the Participant will immediately isolate, notify the Organization, and not attend any of the Organization’s facilities, activities, programs or services until at least 14 days have passed since those symptoms were last experienced.
  7. The Participant has not, nor has any member of the Participant’s household, travelled to, or had a lay-over in any country outside Canada in the past 14 days. If the Participant travels, or if anyone in the Participant’s household travels after submitting this Declaration of Compliance, the Participant will not attend any of the Organization’s facilities, activities, programs or services until at least 14 days have passed since the date of return.
  8. The Participant is following recommended guidelines, including but not limited to, practicing physical distancing, trying to maintain separation of six feet from others, adhering to recognized hygiene best practices, and otherwise limiting exposure to COVID-19.
  9. The Participant will follow the safety, physical distancing, and hygiene protocols of the Organization.
  10. This document will remain in effect until the Organization, per the direction of the provincial government and provincial health officials, determines that the acknowledgements in this Declaration of Compliance are no longer required.
  11. The Organization may remove the Participant from the facility or from participation in the activities, programs or services of the Organization at any time and for any reason if the Organization believes, in its sole discretion, that the Participant is no longer in compliance with any of the standards described in this document.

Today's Date: October 24, 2020

First Participant's Name

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First 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.
Parent or Guardian's Name

First Name*

Last Name*
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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