OC1, Tandem Canoes & Dock COVID HEALTH QUESTIONNAIRE
PLEASE COMPLETE FOR EACH SESSION
Please complete the following questionnaire prior to using the club OC1 canoes. Please answer honestly to describe your health and situation today.
If you have any symptoms or answered 'Yes' to a question, DO NOT use any of the club equipment.
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Name *
Phone number *
Date of paddle *
MM
/
DD
/
YYYY
Time of paddle *
Time
:
List your paddling companions for this session. *
Are you experiencing cold, flu or COVID-19-like symptoms, even mild ones? IF SO, DO NOT USE CLUB EQUIPMENT. Please get a COVID-19 test and self-isolate. *
Required
Have you travelled outside Canada in the last 14 days? IF YES, DO NOT USE CLUB EQUIPMENT. Self-isolate for 14 days. *
Did you provide care or have close contact with a person with confirmed COVID-19 (unless using proper PPE for medical treatment)? IF SO, DO NOT USE CLUB EQUIPMENT. Please get a COVID-19 test and self-isolate for at least 14 days (or longer if you develop symptoms). *
If you are healthy to paddle, we ask that you follow the well-advertised infection-control protocols, including but not limited to, hand hygiene, social distancing, and boat sanitizing
Thank you for helping the club during this difficult time!
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