[Please use form for Winter 2022 at https://forms.gle/S1X7sZu6fqCbiRTZ6]                   - This form is for Fall 2020 and is not to be used for future sessions.   -                
This questionnaire (form) must be completed by every individual prior to participation or entry into the City of Ottawa facility.

Skaters 18 years old and older must be fully vaccinated to enter the arena unless they have a valid medical exemption letter or certificate.

Spectators are allowed in the facility but must sit in the arena stands.
Spectators names must be noted in the questions below.
Spectators 12 years old and older must be fully vaccinated to enter the arena unless they have a valid medical exemption letter or certificate.

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Email *
Skater's Name (first and last, please use same name as registration) *
Your answer
Phone number *
Your answer
Session Date (date you are skating) *
MM
/
DD
/
YYYY
Ice time (please enter the  ice time for your skater's session) *
Time
:
Do you have any of the following symptoms?
A)    Fever (temperature of 37.8C or Higher)
B)    Cough (Continuous, more than usual)
C)    Shortness of breath
D)    Decrease or loss of taste or smell
E)    Nausea, vomiting and / or diarrhea
Symptoms? *
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