September 16 (Thursday) AV ride

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2021 registered members of Ancaster Velo only

First and Last name

I will ride with group: *

4 (23-26km/h)

3 (26-28km/h)

2 (27-30km/h)

1 (30-35+km/h)

I CONFIRM I HAVE NOT: A. Exhibited any COVID-19 symptoms including:• Fever and/or chills• Cough• Difficulty breathing or shortness of breath• Muscle aches• Sore throat or difficulty swallowing• Runny, stuffy or congested nose (not related to seasonal allergies or other known causes)• Lost sense of taste or smell• Extreme tiredness•Any other symptoms as identified by healthexperts (https://www.ontario.ca/page/covid-19-stop-spread#section-0) B.Have not been in contact with someone who is a confirmed or presumptive case of COVID- 19within the last 14 days *

no covid symptoms or exposure

I have symptoms or exposure and will not participate

I am familiar with the ride guide and will come prepared to contribute toward a safe and enjoyable ride. (remember your mask/gloves/sanitizer too) *

yes

no, I'll ride elsewhere today

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