COVID-19 electronic waiver

The World Health Organization has declared the novel Coronavirus (COVID-19) a worldwide pandemic. Due to its capacity to transmit from person-to-person through respiratory droplets, the government has set recommendations, guidelines, and some prohibitions which Pavels Hockey Training (The "Organization") adheres to comply.

In consideration of the participation in the Activity, the undersigned is required to provide the following information: * 


Have you or anyone near you travelled outside of Canada in the last 14 days ?

YESNO

Have you or anyone near you recently experienced a change in health, including: fever, new cough or difficulty breathing, loss of taste or smell (or combination of these symptoms) ? 



YESNO

Do you have muscle aches, fatigue, headache, sore throat, runny nose or diarrhea ?

YESNO

Does anyone near you have COVID-19 (e.g., someone in your household or workplace) ?

YESNO

Are you in close contact with person who is sick with respiratory symptoms (for example, fever, cough or difficulty breathing) who recently travelled outside of Canada ?

YESNO

Select Arena (required)





Waiver/Release : The undersigned agrees that, in using Tecumseh or WFCU Arena (wherever the event takes place) he/she does so entirely at own risk and hereby releases WFCU or Tecumseh Arena & Pavels Hockey Training ,its staff and suppliers from any and all claims associated with the use of the facilities, particularly with respect to exposure to any virus or pathogen including Covid-19.

acknowledge that I have read the Waiver and understand its contents. That I am at least eighteen (18) years old and fully competent to give my consent.  That I have been sufficiently informed of the risks involved and give my voluntary consent in signing it as my own free act and deed with full intention to be bound by the same, and free from any inducement or representation other than my ability to participate in the Activity.
For Minority Age Children (Under 18 Years of Age)
 this is to certify that I, as parent/guardian/adult with responsibility for the below child, have read and explained the provisions in this Waiver to the child including the risks of the Activity and his/her responsibilities for adhering to the rules and regulations put in place by the Organization in connection with their participation in the Activity.



Session date