Summer Day Camps in Manor Park: Pre-Program Declaration of Participant Health 2020

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All parents / guardians must complete this form on behalf of their child (the participant), before their first day of attendance at Summer Day Camps in Manor Park. A separate form must be completed for each child attending.

Child's First & Last Name (Participant) *

Name of parent / guardian completing the declaration of health on behalf of the child. *

Child's start date at Summer Day Camps in Manor Park *

YYYY

Do you confirm that the participant or any member of your household has NOT experienced any of the following symptoms in the past 14 days: cough / difficulty breathing / fever / muscle aches / headaches / chills / loss of taste or smell / sore throat / difficulty swallowing / diarrhea / disorientation / sleeping more than usual / nausea / vomiting / dizziness. *

Yes, I confirm

No, I do not confirm

Do you confirm that the participant has NOT experienced any of the following symptoms in the past 14 days: rash / prolonged fever / red eyes / abnormal swelling of hands or feet. (If the participant has experienced any of these symptoms, a doctors note is required to attend the camp.) *

Yes, I confirm

No, I do not confirm

Required

Please check all that apply: *

The participant has traveled outside of Canada in the past 14 days.

The participant has had close contact with a confirmed or probable case of Covid-19.

The participant has had close contact with a person with acute respiratory illness.

None of the above.

Required

Please check all that apply: *

An adult, over the age of 18, with knowledge of my child's health will be present at camp drop-off and pick-up.

If my child is ill (non-Covid-19 related), my child will not return to camp until they are symptom free for 48 hours.

A parent / guardian will call and report any illness to the camp Supervisor and not send the child to camp.

The ACTIVE SCREENING Questionnaire will be completed for my child each day before arriving at camp.

If my child shows any symptoms or illness during camp hours, they will picked-up immediately.

Waste-free snacks and lunches (encouraged), will be sent with my child to camp with enough food for the day as well as a reusable water bottle

If my child becomes ill during the camp with Covid-19 like symptoms, they will picked-up immediately and brought for testing. Participants can return to camp once they are confirmed Covid-negative and symptoms are resolved for over 48 hours. A doctors note or negative test must be shown prior to return.

I will maintain contact information for parents / guardians and emergency contacts in Amilia account.

All material provided by the Manor Park Community Council will be read, and the information provided will be abided by.

Parent / guardian understands that participant belongings will be stored outside during the day and that no valuable should be sent to camp with the participant.

Parents / guardians acknowledge that they, their friends and their family members are NOT allowed in the Manor Park Community Centre at any time.

Parents / guardians acknowledge that the participant MUST adhere to Public Health's physical distancing and personal hygiene rules. Participants must act in a safe and respectful way while at Summer Day Camps. If a participant is not able to adhere to the rules, they may be asked to leave the program and a refund will not be provided.

Required

Notice of Risk: When children from multiple families attend a day camp, there is an increased risk of the Covidk-19 virus coming into camp. Children who are infected with Covid-19 virus are more likely than adults to have very mild infections or to have no symptoms at all, but these children can still transmit the infection to other children and to adults at camp. This means that children can bring home an infection acquired in a camp and put other persons at risk. Even if a day camp has a screening process to help detect infections when there are no symptoms, this screening process will not detect infected children or adults who do not have symptoms at the time of screening.

I confirm that I have read and understand all of the above, including Notice of Risk, that I have read the Summer Day Camps in Manor Park Parent Handbook and agree to complete the Active Screening Questionnaire for participant before arrival at camp each day. *

Yes, I confirm

Required

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