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This waiver & declaration must be completed prior to use of any of the ice rinks at the CAA Centre.

The novel coronavirus, COVID-19 has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is known to spread mainly by contact from person to person. Consequently, local, provincial and federal governmental authorities recommend various measures and prohibit a variety of behaviors, in order to reduce the spread of the virus.

PA Sports Centre Inc. (“PA Sports”) and its officers, directors, employees and partners commit themselves to comply with the requirements and recommendations of Federal, Provincial and local Public Health and other governmental authorities, and to put in place and adopt all necessary measures to that effect. However, PA Sports cannot guarantee that you (or your child, if participant is a minor/ or the person you are the tutor or legal guardian of) will not become infected with COVID-19. Further, participating in hockey and/or any other activities at the CAA Centre could increase your (or your child, if participant is a minor/ or the person you are the tutor or legal guardian of) risk of contracting COVID-19, despite all preventative measures put in place.

By signing this document,

  1. I acknowledge the highly contagious nature of COVID-19 and I voluntarily assume the risk that I (or my child, if participant is a minor/or the person I am the tutor or legal guardian of) could be exposed or infected by COVID-19 by participating in hockey and/or any other activity at the CAA Centre. Being exposed or infected by COVID-19 may lead to injuries, diseases or other illnesses and could result in death. 
     
  2. I declare that I (or my child, if participant is a minor/ or the person I am the tutor or legal guardian of) am participating in hockey and/or other activities at the CAA Centre voluntarily. 
     
  3. I declare that neither I (or my child, if participant is a minor/or the person I am the tutor or legal guardian of) nor anyone in my household, have experienced cold or flu-like symptoms in the last 14 days (including fever, cough, sore throat, respiratory illness, difficulty breathing).
     
  4. I declare that neither I (or my child, if participant is a minor/ or the person I am the tutor or legal guardian of), nor any member of my household have travelled to or had a lay-over in any country outside Canada, or in any Province outside of Ontario, in the past 14 days.
     
  5. I (or my child, if participant is a minor/or the person I am the tutor or legal guardian of) agree to the requirements and recommendations of Federal, Provincial and local Public Health and other governmental authorities and to those special safety regulations put in place by PA Sports as it pertains to COVID-19 and to adopt all necessary measures to those effects.
     
  6. By executing this waiver, I accept and assume full responsibility for any and all injuries, illness, damages (both economic and non-economic), and losses of any type, which may occur to me (or my child, if participant is a minor/or the person I am the tutor or legal guardian of) and I hereby fully and forever release and discharge PA Sports, its employees, partners, officers, directors, and associates, from any and all claims, demands, damages, rights of action, or causes of action, present or future, whether the same be known or unknown, anticipated, or unanticipated, resulting from or arising from participating in hockey and/or other activities at the CAA Centre.


By signing this waiver the participant also agrees to answer the following health screening questions EACH TIME prior to entering the CAA Centre:

1. You do NOT have any of the following new or worsening symptoms or signs:

               Fever or chills
               Difficultly breathing or shortness of breath
               Cough 
               Sore throat, trouble swallowing
               Runny nose/Bystuffy nose or nasal congestion
               Decrease or loss of smell or taste
               Nausea, vomiting, diarrhea, abdominal pain
               Not feeling well, extreme tiredness, sore muscles

2. You have NOT travelled outside of Canada in the past 14 days; and

3. You have NOT had close contact with a confirmed or probable case of COVID-19.

If you answered NO to all questions from 1 through 3, you have passed and can enter the CAA Centre.

If you answered YES to any questions from 1 through 3, you have not passed and should not enter the CAA Centre.  You should go home to self-isolate immediately and contact your health care provider or Telehealth Ontario (1-800-797-0000) to find out if you need a COVID-19 test.

I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTAND IT, SIGNED THIS DOCUMENT FREELY AND WITH FULL KNOWLEDGE.

Today's Date:  December 2, 2020


 

 

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*
Check to receive information, news, and discounts by e-mail.
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 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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