DECA - Declaration of Compliance - COVID
I, the undersigned being the Participant and/or the Participant’s Parent/Guardian (if the Participant is under the age of majority), hereby acknowledge and agree to the terms outlined in this document:

1. The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization and COVID-19 is extremely contagious. The Organization has put in place preventative measures to reduce the spread of COVID-19 and requires all participants (or their parent/guardian, when applicable) to adhere to the compliance standards described in this document.
2. The Participant has not been diagnosed with COVID-19, OR if the Participant was diagnosed with COVID-19, the Participant was cleared as non contagious by provincial or local public health authorities more than 14 days prior to the date this Declaration of Compliance was signed.
3. The Participant has not been exposed to a person with a confirmed or suspected case of COVID-19; OR if the Participant was exposed to a person with a confirmed or suspected case of COVID-19, the date of exposure was more than 14 days prior to the date this Declaration of Compliance was signed.
4. The Participant is participating voluntarily and understands and assumes the risks associated with COVID-19. The Participant (or the Participant’s parent/guardian, on behalf of the Participant (when applicable) agrees to assume those risks, including but not limited to exposure and being infected.
5. The Participant has not, nor has anyone in the Participant’s household, experienced cold or flu-like symptoms in the last 14 days (including fever, cough, sore throat, shortness of breath, respiratory illness, difficulty breathing). If the Participant experiences, or if anyone in the Participant’s household experiences, any cold or flu-like symptoms after submitting this Declaration of Compliance, the Participant will immediately isolate and not attend any of the Organization’s activities, programs or services until at least 14 days have passed since those symptoms were last experienced.
6. The Participant has not, nor has any member of the Participant’s household, travelled to or had a lay-over in any country outside Canada, in the past 14 days. If the Participant travels, or if anyone in the Participant’s household travels, outside of Canada after submitting this Declaration of Compliance, the Participant will not attend any of the Organization’s activities, programs or services until at least 14 days have passed since the date of return.
7. The Participant is following recommended guidelines, including but not limited to, practicing physical distancing, trying to maintain separation of six feet from others, frequent handwashing, and otherwise limiting exposure to COVID-19. The Participant will follow the safety, physical distancing and hygiene protocols of the Organization. DECA Program Coordinators/Instructors reserve the right to administer temperature checks for program participants at their discretion.

This document will remain in effect until the Organization, per the direction of the provincial government and provincial health officials, determines that the acknowledgements in this Declaration of Compliance are no longer required. The Organization may remove the Participant from participation in the activities, programs or services of the Organization at any time and for any reason if the Organization believes, in its sole discretion, that the Participant is no longer in compliance with any of the compliance standards described in this document.
Which Program are you attending? *
Required
What is your LAST name? *
What is your FIRST name? *
Please provide your email address *
Please provide your phone number *
I Agree/Disagree to the above terms of the Declaration of Compliance: *
Date Signed *
MM
/
DD
/
YYYY
Submit
Never submit passwords through Google Forms.
This form was created inside of decaregina.ca. Report Abuse