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DECLARATION OF COMPLIANCE – COVID-19

WARNING!

ALL INDIVIDUALS MUST COMPLY WITH THIS DECLARATION


BC Wheelchair Sports Association and its member clubs (collectively the “Organization”) require the disclosure

of exposure or illness in order to safeguard the health and safety of all participants and limit the further

outbreak of COVID-19 and other contagious disease. 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 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 individual named above and the individual’s parent/guardian (if the individual 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 individuals (or their parent/guardian, when

applicable) to adhere to the compliance standards described in this document.


2) The individual has not been diagnosed with COVID-19; OR If the individual was diagnosed with COVID-19,

the individual is permitted to end their isolation as determined by Public Health by meeting the following 3 criteria: at least 5 days have

passed since the onset of symptoms or a positive test (if no symptoms); fever (if present) has resolved without the use of medications

AND symptoms have improved or subsided.


3) 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 (when applicable)) agrees to

assume those risks, including but not limited to exposure and being infected.


4) The individual is not currently experiencing 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). OR if the individual is experiencing mild symptoms as above it has been at least 5 days since the onset of symptoms or a positive

test in the case of no symptoms.  


5) If the individual experiences any signs or symptoms of COVID-19 after submitting this Declaration of Compliance, the individual will

follow the guidance of Public Health (and the Organizing Committee in the case of an event) AND not attend any of the Organization’s

facilities, activities, programs or services until at least 5 days have passed since those symptoms were first experienced. 


6) The individual is following recommended guidelines and protocols of the Provincial Government.


Furthermore, by signing below, the Participant or the Participant’s Guardian agrees that while attending or

participating in the Organization's events or attending at the Organization’s facilities, the Participant:


1. Will follow the safety hygiene protocols of the Organization as outlined in the

BCWSA Return to Sport Guidelines for their sport.


2. Will, in the event that the Participant experiences any symptoms of illness such as a fever, cough,

difficulty breathing, shortness of breath or malaise, immediately:


a. Inform a representative of the Organization; and

b. Depart from the event or facility.


3. Acknowledges that the Organization may remove the individual 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 individual is no longer in compliance with any of

the standards described in this document.


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.



First Participant's Name

First Name*

Last Name*

Phone*
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*
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*

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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