Declaration of Compliance & Assumption of Risk - Over 18

PULSARS GYMNASTICS CLUB

DECLARATION OF COMPLIANCE – COVID-19

 

Participant’s Name           [FIRST NAME] [LAST NAME]

 

Email:                                      [EMAIL ADDRESS]

 

Telephone:                             [PHONE]

 

WARNING! 

ALL PARTICIPANTS ENTERING THE FACILITY MUST COMPLY WITH THIS DECLARATION

 

Gymnastics Ontario and Pulsars Gymnastics Club (collectively the “Organization”) require the disclosure of exposure or illness is in order to safeguard the health and safety of all participants and limit the further outbreak of COVID-19.  This Declaration of Compliance will be kept safely, and personal information will not be disclosed unless as required by law or with your consent.

 A participant (or the participant’s parent/guardian, if the participant is younger than 18 years old) who is unable to agree to the terms outlined in this document is not permitted to enter the Organization’s facilities or participate in the Organization’s activities, programs, or services.

 I, the undersigned being the participant named above and the participant’s parent/guardian (if the participant is younger than 18 years old), 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 noncontagious 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.  However, if the participant was exposed to a person with a confirmed 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 attending or participating voluntarily and understands 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 breach, respiratory illness, difficulty breathing).

 

6)      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 facilities, activities, programs or services until at least 14 days have passed since those symptoms were last experienced. 

 

7)      The participant has not, nor has any member of the participant’s household, traveled to, or had a lay-over in any country outside Canada, or in any province outside of Ontario in the past 14 days. If the participant travels, or if anyone in the participant’s household travels, outside the Province of Ontario after submitting this Declaration of Compliance, the participant will not attend any of the Organization’s facilities, activities, programs or services until at least 14 days have passed since the date of return. 

 

8)      The participant is following recommended guidelines, including but not limited to, practicing physical distancing, trying to maintain separation of six feet from others, frequent hand washing, and otherwise limiting exposure to COVID-19.

 

9)      The participant will follow the safety, physical distancing, and hygiene protocols of the Organization.

 

10)  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.

 

11)  The Organization may remove the participant from the facility or 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.

 

 

 Signature:       

Sign Here          Date:  09/17/2021

                         

 

 

GYMNASTICS ONTARIO and Pulsars Gymnastics Club

INFORMED CONSENT AND ASSUMPTION OF RISK AGREEMENT

2020-2021

 

 WARNING!   Please read carefully

By signing this document, you will assume certain risks and responsibilities

 

Participant’s Name: [FIRST NAME] [LAST NAME]

1.       This is a binding legal agreement. Clarify any questions or concerns before signing. As a participant in the sport of gymnastics and the spectating, orientation, instruction, activities, competitions, programs, and services of Gymnastics Ontario and Pulsars Gymnastics Club (collectively the “Activities”), the undersigned, being the Participant and the Participant’s Parent/Guardian (if Participant is under 18 years old), (collectively the “Parties”), acknowledge and agree to the terms outlined in this document.

2.       Gymnastics Ontario, Pulsars Gymnastics Club, and their respective Directors, Officers, committee members, members, employees, coaches, volunteers, officials, participants, agents, sponsors, owners/operators of the facilities in which the Activities take place, and representatives (collectively the “Organization”).

Initial Here     We have read and agree to be bound by paragraphs 1 and 2

 

Description and Acknowledgement of Risks

3.       The Parties understand and acknowledge that:

a)     The Activities have foreseeable and unforeseeable inherent risks, hazards, and dangers that no amount of care, caution or expertise can eliminate, including without limitation, the potential for serious bodily injury.

b)    The Organization may offer or promote online programming (such as webinars, remote conferences, workshops, and online training) which have different foreseeable and unforeseeable risks than in-person programming.

c)     The Organization has a difficult task to ensure safety and it is not infallible. The Organization may be unaware of the Participant’s fitness or abilities, may give incomplete warnings or instructions, may misjudge weather or environmental conditions, and the equipment being used might malfunction.

d)    The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization and COVID-19 is contagious. The Organization has put in place preventative measures to reduce the spread of COVID-19; however, the Organization cannot guarantee that the Participant will not become infected with COVID-19. Further, participating in the Activities could increase the Participant’s risk of contracting COVID-19.

4.       The Participant is participating voluntarily in the Activities. In consideration of that participation, the Parties hereby acknowledge that they are aware of the risks, dangers and hazards and may be exposed to such risks, dangers, and hazards. The risks, dangers and hazards include, but are not limited to:

a)     Privacy breaches, hacking, technology malfunction or damage.

b)    Executing strenuous and demanding physical techniques and exerting and stretching various muscle groups.

c)     Vigorous physical exertion, strenuous cardiovascular workouts, and rapid movements.

d)    The failure to properly use any piece of equipment or from the mechanical failure of any piece of equipment or apparatus.

e)    Failure to follow instructions or rules.

f)      Serious injury to virtually all bones, joints, ligaments, muscles, tendons, and other aspects of the Participant’s body or to the Participant’s general health and well-being.

g)     Abrasions, sprains, strains, fractures, or dislocations.

h)    Concussion or other head injuries, including but not limited to, closed head injury or blunt head trauma.

i)      Physical contact with other participants, spotters, spectators, equipment, and hazards.

j)      Collisions with walls, any gymnastics apparatus, floors, or mats.

k)     Falling, tumbling, or hitting any gymnastics apparatus, the floor, mats, or other surfaces.

l)      Failure to act safely or within the Participant’s ability or designated areas.

m)  Negligence of other persons, including other spectators, participants, or employees.

n)    Travel to and from competitive events and associated non-competitive events which are an integral part of the Activities.

o)    Contracting COVID-19 or any other contagious disease.

 

Initial Here     We have read and agree to be bound by paragraphs 3 and 4

 

Terms

5.       In consideration of the Organization allowing the Participant to participate in the Activities, the Parties agree:

a)     That when the Participant practices or trains in their own space, the Parties are responsible for the Participant’s surroundings and the location and equipment that is selected for the Participant.

b)    That the Participant’s mental and physical condition is appropriate to participate in the Activities and the Parties assume all risks related to the Participant’s mental and physical condition.

c)     That the Participant may experience anxiety while challenging themselves during the Activities.

d)    To comply with the rules and regulations for participation in the Activities.

e)    To comply with the rules of the facility or equipment.

f)      The risks associated with the Activities are increased when the Participant is impaired, and the Participant will not participate if impaired in any way.

g)     That COVID-19 is contagious in nature and the Participant may be exposed to, or infected by, COVID-19.

6.       In consideration of the Organization allowing the Participant to participate, the Parties agree:

a)     That the Parties are not relying on any oral or written statements made by the Organization or their agents, whether in brochure or advertisement or in individual conversations, to agree to participate in the Activities.

b)    That the Organization is not responsible or liable for any damage to the Participant’s vehicle, property, or equipment that may occur as a result of the Activities; and

c)     That this Agreement is intended to be as broad and inclusive as is permitted by law of the Province of Ontario and if any portion thereof is held invalid, the balance shall, notwithstanding, continue in full legal force and effect.

 

Jurisdiction

7.       The Parties agree that in the event that they file a lawsuit against the Organization, they agree to do so solely in the Province of Ontario.

 

Initial Here  We have read and agree to be bound by paragraphs 5 to 7

 Acknowledgement

8.       The Parties acknowledge that they have read this Agreement and understand it, that they have executed this Agreement voluntarily, and that this Agreement is to be binding upon themselves, their heirs, their spouses, parents, guardians, next of kin, executors, administrators and legal or personal representatives.            

 

[FIRST NAME] [LAST NAME]                   

Sign Here                                   09/17/2021

Name                                                                              Signature                                               Date

 

[ADDRESS]

Address


Signee Information

Sign Here

By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.