1. Authorization and RELEASE: I, in my personal capacity and on behalf of the participant, do hereby RELEASE FROM ALL LIABILITY Silverheights Neighbourhood Association, its Directors, volunteers, employees, agent and representatives (hereinafter Releasee) for any injuries, illnesses, or other mishap that may be incurred by the participant while attending a registered, drop in or online program or event, except where damage or injury is caused by the gross negligence of the Releasee. In the event the participant should be injured or become ill, I authorize any medical treatment that may be required and will assume full financial responsibility for the said treatment. At no time is the Releasee liable for the action/inaction of any support worker supplied by and/or for the participant. 2. Personal Information collected on this form is obtained incompliance with the Personal Health Information Protection Act (PHIPA) and will used only for the purpose of the SNA. Questions about the collection of personal information should be directed to the SNA Health Information Custodian by calling 519-249-1200. 3. I understand that this form shall be completed no less than each calendar year. 4. I, the Participants Legal Guardian, agree not to share links and meeting I.D. information with outside parties who are not registered with Silverheights Neighbourhood Association and am aware of the risks and dangers associated in sharing information. I acknowledge and fully understand, appreciate and accept the inherent risks associated with my child’s participation in virtual and online activities provided by Silverheights Neighbourhood Association BY SIGNING THIS RELEASE YOU ARE RELEASING YOUR LEGAL RIGHTS AGAINST SNA. 5. Legal has modified and approved the required wording to be included in the Program Readiness section of the intake process for modified programs (taken from the Covid 19 portion of the the Region of Waterloo Children's Services Application & Consent Form that is used during their Child Care Intake): While Silverheights Neighbourhood Association will be making best reasonable efforts to reduce the risk of the spread of Covid 19 virus (the “Covid Virus”) within its programs facilities, I acknowledge that the current Covid Virus pandemic in Ontario and Canada is ongoing, and agree that Silverheights Neighbourhood Association can in no way can guarantee that my child or children that are receiving childcare pursuant to this agreement, or myself or any other authorized person entering Silverheights Neighbourhood Associations premises to pick up or drop off such child will not become infected with the Covid Virus.In addition to the above, each camper will have to complete our Child Readiness Form and a the pre-screening as required by the operating guidelines. *
