TATC Covid-19 Daily Patron Screening Form
Please complete the below questionnaire prior to your visit to TATC and on the same day as your booking/activity.

REMINDER – THIS FORM IS ONLY VALID IF COMPLETED ON THE DAY OF YOUR ACTIVITY.

This form must be completed PRIOR to each entrance to TATC if you have not filled in the advanced booking form.
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Email *
Member/Participant Full Name (First & Last) *
Key Number *
Parent/Guardian Full Name (First & Last) *or N/A *
Activity *
Date of your Booking/Activity *
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/
DD
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Start Time of Your Booking/Activity *
Time
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Do you (participant and/or supervising parent/guardian) currently have any COVID-19 related symptoms? (fever, chills, cough, difficulty breathing, sore throat, difficulty swallowing, runny nose, loss of taste/smell, pink eye/conjunctivitis, headache, muscle aches, extreme tiredness, falling down often, diarrhea, nausea, vomiting, abdominal pain or nasal congestion) * *
Is anyone you live with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms? * *
In the last 14 days, have you or anyone you live with travelled outside of Canada? If exempt from quarantine requirements (for example, an essential worker who crosses the Canada-US border regularly for work), select “No.” *
Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)? This can be because of an outbreak or contact tracing. *
In the last 14 days, have you received a COVID Alert exposure notification on your cell phone?If you already went for a test and got a negative result, select “No.” *
If you answered YES to any of the screening questions above, go home & self-isolate right away. Visit OttawaPublicHealth.ca/Coronavirus for more information as you may be eligible for a COVID-19 test. If feeling unwell, contact your health care provider or call Telehealth Ontario at 1-866-797-0000 to speak to a registered nurse.
By agreeing, I acknowledge that all information provided submitted in this form is accurate, and I have agreed to follow the policies and procedures put in place by TATC upon entering the grounds. *
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TATC Covid-19 Participant Waiver and Information WITH THE ACTION OF BOOKING A COURT, PRIVATE LESSON, PLAYING OR PARTICIPATING IN A PROGRAM OR BOOKING, IT IS ASSUMED THAT YOU HAVE READ AND AGREED TO THE RISK AND PROTOCOLS IN PLACE AT TATC.
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By clicking YES, I declare that I have read, understood and that I agree to the contents of this ASSUMPTION OF RISK AND INFORMED CONSENT AGREEMENT and RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT in its entirety. * By clicking YES, I have read and understood the following protocols, guidelines and recommendations: RE: TATC COVID-19 PROTOCOLS, and the Ottawa Public Health’s (OPH) recommendations. *
A copy of your responses will be emailed to the address you provided.
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