Masjid COVID 19 Liability Waiver
We will confirm by email the receipt of your waiver.
The first 30 people who come and have submitted the waiver will be allowed inside.
• Please be advised that children below the age of 15 will not be allowed.
• Seniors over the age of 60 and people with underlying health conditions are discouraged from attending.
• If anyone is sick, please stay at home.
• Everyone must wear a mask at all times while in the Masjid.
• Please give salam verbally. Avoid shaking hands and hugging.
• Please adhere to physical distancing at all times while at the Masjid.
• Bring your own prayer mat and take it back with you.
• Perform Wudhu (ablution) at home. Wudhu and washroom facilities will be closed.
• Pray Sunnah prayers at home.
• Please don't socialize in the Masjid or in the Masjid parking lot.
• Cover your sneeze and cough with your sleeve or a tissue.
• Please don't gather at the entrance. Please wait inside your cars until the doors are opened.
• After Fardh, please leave the Masjid right away.
• Take all precautions suggested by our government!
• We request everyone to adhere by the rules.
Email *
First Name *
Last Name *
Phone Number *
Date *
Please read the following and sign below. By signing below you acknowledge each of the following statements and hold no liability towards the masjid.
- I acknowledge the contagious nature of the Coronavirus (“COVID-19”) and that public health authorities still recommend practicing social distancing.

- I further acknowledge that Masjid Zakariya (“the Masjid”) cannot guarantee that I will not become infected with Covid-19. I understand that the risk of becoming exposed to and/or infected by the COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to Masjid staff, volunteers, and other congregants and their families.

- I voluntarily seek to enter the Masjid and acknowledge that I am increasing my risk of exposure to COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending the Masjid.

- I attest that:

⮚ I am not experiencing any symptoms of illness such as a cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.

⮚ I have not traveled internationally within the last 14 days

⮚ I have not traveled to an impacted area within Canada in the last 14 days

⮚ I do not believe I have been exposed to someone with a suspected and/or confirmed case of COVID-19

⮚ I have not been diagnosed with and not yet cleared as non-contagious by provincial or local public health authorities

⮚ I am following all recommended guidelines as much as possible and limiting my exposure to COVID-19

⮚ I will notify the masjid immediately if I have tested positive for COVID-19, so that the musjid may take appropriate measures to avoid the spread of the illness

- I hereby release and agree to hold Masjid Zakariya harmless from and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of the Masjid, or that may otherwise arise in any way in connection with my entry to the Masjid. I understand that this release discharges Masjid Zakariya from any liability or claim that I, my heirs, or any personal representatives may have against the Masjid with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to entering the Masjid. This liability waiver and release extends to the Masjid together with all volunteers, staff, and employees.
Please e-sign below with your full name. *
A copy of your responses will be emailed to the address you provided.
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