GPWC Covid Daily Attestation

INSTRUCTIONS:
1. To comply with Return to Sport, this form must be completed ONE HOUR before each practice.
2. If athlete is under 18, the PARENT MUST COMPLETE THIS FORM USING PARENT EMAIL NOT WRESTLER'S EMAIL.
3. If form is not submitted, participant will NOT be able to partake in the practice.

4. PLEASE READ THE FOLLOWING

Please note that by completing this form and submitting it to Adam Link C/O of the Grande Prairie Wrestling Club, the Participant (named below) or the Participant’s Guardian attests that the Participant is able to participate in wrestling practice because the participant:

1. Does not knowingly have COVID-19;
2. Is not experiencing any known symptoms of COVID-19, such as fever, cough, shortness of breath or
malaise;
3. Has not travelled internationally during the past 14 days;
4. Has not frequented a COVID-19 high risk area in the Province during the last 14 days;
5. Has not, in the past 14 days, knowingly come into contact with someone who has COVID-19, who
has known symptoms of COVID-19, or is self-quarantining after returning to Canada; and
6. Has been following government recommended guidelines in respect of COVID-19, including
practicing physical distancing.

Furthermore, by completing 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 laws, recommended guidelines, and protocols issued by the Government of the Province in respect of COVID-19, including practicing physical distancing, and will do so to the best of the Participant’s ability while participating in the Organization's events or attending at the Organization’s facilities;
2. Will follow the guidelines and protocols mandated by the Organization in respect of COVID-19;
3. 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.

FOR PARTICIPANTS WHO HAVE BEEN DIAGNOSED WITH COVID-19:
By signing below, the Participant (named below) or the Participant or the Participant’s Guardian attests that the Participant has been diagnosed with COVID-19, but been cleared as noncontagious by provincial or local public health authorities and has provided to the Organization, in conjunction with this COVID-19 ATTESTATION AND AGREEMENT, written confirmation from a medical doctor of the same.


Email address *
Today's Date *
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Participant Full Name *
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Wrestling Group *
Parent/Guardian (if under 18) Full Name
Contact Number (**If under 18 please provide PARENT CELL NUMBER) *
COVID Screening checklist - I have gone through the Screening Checklist. I understand that if the participant has answered YES to any of the questions, they WILL NOT be allowed to participate in the sport or activity.Children and youth will need a parent to assist them to complete this screening tool. *
SIGNATURE By checking the box below, this serves as a signature for either the participant or parent/guardian (if under 18) *
Required
Submit
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