Covid 19 Restriction Exemption Waiver & Attestation
This form must be completed and submitted prior to entry and use of any facility that is hosting a Alberta Netball Association (ANA) sanctioned event.

On September 15th 2021 AB Government announced the implementation of the Restriction Exemption Program (REP), (see link below) - Effective Sept 20th, 2021.

 As a sports organization ANA falls within the in-scope operators as detailed in the order. To deliver Netball to our membership ANA will participate in the REP, but must follow or exceed the program requirements at all times, including requiring all patrons/attendees aged 12 and over to provide valid:

o Proof of vaccination*; or
o Proof of a negative, privately-paid test result from a sample that is taken within the prior 72 hours (Results from Alberta Health Services are not eligible for consideration for this program), or
o An original (non-copied) medical exemption letter.

 *In the circumstances where a single dose of vaccine can be proven it must have been administered two weeks prior to the date of participation. A record of proof of vaccine will be stored in the form of a check mark

Assumption of Risks:
I am aware that participating in the activities and sport of netball, without limitation, offered by or associated with ANA, exposes me to many inherent risks, dangers and hazards. By engaging in any activities offered by or associated with ANA, I freely accept and fully assume all inherent risks, dangers and hazards and the possibility of personal injury, death, property damage or loss resulting there from.

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization and COVID-19 is extremely contagious. The ANA has put in place preventative measures to reduce the spread of COVID-19; however, I understand that the ANA cannot and does not guarantee that I will not become infected with COVID-19. Further, participating in any group activity or game play may significantly increase my risk of contracting COVID-19 and such exposure may result in temporary or permanent personal injury, illness, disability or death and I freely and voluntarily agree to assume all the foregoing risks.

By completing this form, the Participant (named below) or the Participant’s Guardian attests that the Participant:
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Email *
Name of Participant: *
I attest to the fact that I/the participant *
Yes
No
Not Applicable
do(es) not knowingly have COVID-19
is not experiencing any known symptoms of COVID-19, such as fever, cough, shortness of breath or malaise, sore throat
has not travelled Internationally within the last 14 days
have not frequented a COVID-19 high risk area in the Province during the last 14 days
has followed government recommended guidelines in respect of COVID-19, including practicing physical distancing and wearing the appropriate PPE where necessary
will follow the guidelines and protocols mandated by the Association in respect of COVID-19 and the Restriction Exemption Program
will in the event that I/the particpant experience any symptoms of illness such as fever, cough, shortness of breath or malaise, sore throat, immediately notify a representative of the league and/or ANA
have been previously diagnosed with COVID-19, but have been declared as non-contagious by Provincial or local public health authorities, and has provided to the Organization, in conjunction with this COVID-19 Restriction Exemption Attestation & Waiver, written confirmation from a medical doctor of the same
have provided proof of vaccination
have provided proof of a negative COVID-19 test, obtained within the prior 72 hours
have provided a proof of medical exemption letter
Content Disclaimer
The COVID-19 (Coronavirus) outbreak is an ongoing, rapidly developing situation. Alberta Netball Association encourages it's membership to monitor publicly available information and to always follow Federal, Provincial and local health organization guidance and Government mandates.

The information provided herein in part is obtained from publicly available sources, including federal and provincial government entities. This information may vary and will be updated depending upon current situations.
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