COVID-19 Health Declaration Please complete this form ON THE DAY of your arrival to the Richmond Olympic Oval to display that you are free of COVID-19 related symptoms. If your answer is YES to any of the questions, you are not permitted to visit the Oval. Separate from the completion and submission of this form, the BC Self-Assessment Tool can be found via the below link. It is not a diagnostic tool and does not replace the advice of your healthcare provider. https://bc.thrive.health/ The Richmond Olympic Oval (the “Oval”) and the Richmond Rockets Speed Skating Club (the "Club") cares for the health and wellbeing of its visitors, staff and community. To ensure the safety of all that frequent the Oval, we ask that you practice social/physical distancing and recommended sanitation measures during your visit. Prior to confirming your booking, please: (1) Complete the following Health Questionnaire; (2) Review the Oval’s Conditions of Entry; and (3) Waiver of Liability Form.Name *Date of VisitPhoneEmail AddressGroupGroup 1Group 2Are you experiencing any of the following: Severe difficulty breathing (e.g. struggling to breathe or speaking in single words), Severe chest pain, Having a very hard time waking up, Feeling confused, Losing consciousness? *YesNoAre you experiencing any of the following: Mild to moderate shortness of breath, Inability to lie down because of difficulty breathing, Chronic health conditions that you are having difficulty managing because of difficulty breathing? *YesNoAre you experiencing cold, flu or COVID-19-like symptoms, even mild ones? Symptoms include: Fever, chills, cough or worsening of chronic cough, shortness of breath, sore throat, runny nose, loss of sense of smell or taste, headache, fatigue, diarrhea, loss of appetite, nausea and vomiting, muscle aches. While less common, symptoms can also include: stuffy nose, conjunctivitis (pink eye), dizziness, confusion, abdominal pain, skin rashes or discoloration of fingers or toes. Fever: Average normal body temperature taken orally is about 37°C. For more on normal body temperature and fevers, see HealthLinkBC's information for children age 11 and younger and for people age 12 and older. *YesNoHave you travelled to any countries outside Canada (including the United States) within the last 14 days? YesNoDid you provide care or have close contact with a person with confirmed COVID-19? Note: This means you would have been contacted by your health authority’s public health team. YesNoResult:PASSEDConditions of EntryPersonal Conduct During Your VisitYou shall comply with all rules and regulations of the Oval and the Club. You shall be held financially responsible for any damage to the Oval or loss of or damage to any equipment resulting from your use of the Oval’s or the Club's equipment. Your use of the Oval shall not cause unreasonable interference with the orderly functioning of the Oval and the Club or infringe upon the rights or privileges of users of the Oval. Your use of the Oval shall not promote hatred or discrimination against, or expose to contempt, any person or group of persons contrary to applicable law. You shall act in a considerate, legal and sportsmanlike manner when using or occupying the Oval. Abusive language or illegal or inconsiderate behaviour may result in the cancellation of your right to use the Oval or termination of Club membership. You shall comply with all rules and regulations established from time to time by the Oval and the Club. The Oval shall have the right at any time to eject you and others from the Oval and the Club or to refuse admittance thereto of any person or persons who, in the opinion of the Oval or the Club is or are creating a disturbance or behaving in an illegal, objectionable or improper manner. You agree that while participating in the Oval and Club your conduct will at all times be such that it presents no danger to other Oval and Club users or staff, and does not interfere with the enjoyment of other guests or staff, or disrupt the staff in performing their duties. The Oval and the Club reserves the right to take whatever action deemed necessary to ensure all visitors to the Oval comply with Oval and Club rules, regulations and privileges. The Club, may, in its absolute discretion, suspend or cancel the right and privileges of membership for any reason at any time.Assumption of Risks and Release of LiabilityPLEASE READ CAREFULLYIn consideration of being allowed to participate in Club activities at the Oval, I acknowledge and agree that: the risk of injury from the activities involved is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce the risk, the risk of serious injury does exist. I acknowledge that it is my responsibility to advise the Richmond Olympic Oval Corporation (“Oval Corp.”) of any medical or other conditions which may affect my participation in any program or training sessions; and the novel coronavirus, COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, provincial and local governments and recommend social distancing. the Club and Oval Corp. has put in place preventative measures to reduce the spread of COVID-19. However, Oval Corp. and the Club cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending the Oval could increase your risk and your child(ren)’s risk of contracting COVID-19. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF OVAL CORP. , THE CLUB or others, and assume full responsibility for my participation. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Oval Corp., the Richmond Rockets Speed Skating Club, City of Richmond, their owners, coaches, contractors and/or employees, and, if applicable, lessees of Oval Corp., WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, SICKNESS, INFECTION, DISEASE, DEATH, or loss or damage to person or property, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE. In the event that I require medical attention, I consent to be transported to the nearest emergency centre and receive medical treatment, including by ambulance if necessary, and accept that I am responsible for any costs of such ambulance service. A PARENT or LEGAL GUARDIAN must consent to and agree to the terms and conditions outlined in this document if you are a minor. (Age 18 or Younger) I consent to my child’s participation at the Club. I am aware that there are risks associated with participation in all Club activities at the Oval, including the risk of injury and having my child exposed to or infected by COVID-19. I consent to my child’s participation in spite of such risks. I consent to permit the staff of the Club to take my child/guardian on outings to public spaces that may involve transportation in a vehicle. I acknowledge that it is my responsibility to advise the Club of any medical or other conditions which may affect my child’s participation. In the event that my child requires medical attention, I consent to my child being transported to the nearest emergency centre and receiving medical treatment, including by ambulance if necessary, and accept that I am responsible for any costs of such ambulance service. I HAVE READ THIS HEALTH QUESTIONNAIRE AND WAIVER AND RELEASE OF LIABILITY FORM, FULLY UNDERSTAND ITS TERMS, AND I UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY AGREEING TO ITS TERMS, AND AGREE TO ITS TERMS FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. I FURTHER UNDERSTAND THAT THE TERMS OF THIS WAIVER WILL APPLY TO MY VISITS TO THE OVAL FOR THE NEXT FIVE YEARS. *I AgreeSend DeclarationPlease do not fill in this field.