Covid-19 Waiver C-K Plowing Match 2021

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Please complete the following Covid-19 Waiver Form to attend the 2021 Chatham-Kent Plowing Match.

Things to bring:
- a mask, sunscreen, hat
- pack a lunch, there will be no food/drinks available for purchase on site

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Are you a? *

Event Attendee

Volunteer

Full Name (First and Last) *

Street Address *

City *

Postal Code *

Phone Number *

E-mail Address *

Full Name of Parent or Guardian if under the age of 18

Covid-19 Waiver Form (Select the checkbox to answer Yes to each of the following) *

1. Covid-19 is highly contagious and I voluntarily assume the risk that I or my child may be exposed to or infected by Covid-19 by participating in the Chatham-Kent plowing match; and that such exposure or infection may result in personal injury, illness, permanent disability, or death to myself, my child or other family members or individuals that we may interact with outside of the Chatham-Kent plowing match. I understand that many public health authorities may still recommend practicing social distancing.

2. I understand and acknowledge that the risk of myself or my child becoming exposed to or infected by Covid-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, volunteers, match participants and spectators. I further agree and acknowledge that I am increasing the risk of myself or my child becoming exposed to or infected by Covid-19 by participating in the Chatham-Kent plowing match.

3. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself, my child, and other family members or individuals that we may interact with outside of the Chatham-Kent plowing match, including, but not limited to, personal injury, disability, and death, illness, damage, loss, claim, liability, or expense, of any kind, that I, my child or other family members or individuals that we may interact with outside of the Chatham-Kent plowing match may experience or incur in connection with my or my child participating in the Chatham-Kent plowing match.

4. On my behalf, (and on behalf of my child), our heirs, any personal representatives, and next of kin, I hereby release, covenant not to sue, discharge, and hold harmless the Chatham-Kent Plowmen’s Association, and their respective volunteers, agents, representatives, and affiliates, of and from all claims, including all liabilities, claims, actions, damages, costs or expenses of any kind, arising out of or relating thereto. I understand and agree that this release includes any claims based on the actions, omissions, or negligence of the Chatham-Kent Plowmen’s Association or their respective volunteers, agents, representatives, and affiliates, whether a Covid-19 infection occurs before, during or after participation in the Chatham-Kent Plowing Match.

5. I understand that by signing this document, I agree that if I or my child are exposed to or infected by Covid-19 during participation in the Chatham-Kent Plowing Match, then I or my child may be found by a court of law to have waived our right to maintain a lawsuit for a claim of negligence.

6. I represent that neither I, (nor my child,) have any medical or physical condition which could interfere with our safety in participating in the Chatham-Kent Plowing Match, or else I am willing to assume the risk of and bear the costs of all risks that may be created, directly or indirectly, by any such condition.

7. I have had sufficient time to read this entire document and, should I choose to do so, consult with legal counsel prior to signing. Also, I understand that this activity might not be made available to me or my child if I were to choose not to assume the risks herein and waive the rights herein, and I agree that the opportunity to participate in return for the execution of this document is a reasonable bargain.

8. I agree that I will practice safe social distancing and clean hygiene during my participation in the Chatham-Kent Plowing Match.

9(a). Neither myself (nor my child) are experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell, and I agree that my child and/or I will not participate in the Chatham-Kent Plowing Match if we are experiencing symptoms of illness.

9(b). Neither myself (nor my child) have traveled internationally within the last 14 days, and I agree that neither my child nor I will participate in the Chatham-Kent Plowing Match if I/we have traveled internationally within 14 days of the match.

9(c). Neither myself (nor my child) have traveled to a highly impacted area within Canada in the last 14 days, and I agree that neither my child nor i will participate in the Chatham-Kent Plowing Match if we have traveled to a highly impacted area within Canada within 14 days of the match.

9(d). Neither I (nor my child), have been diagnosed with Covid-19 and not yet cleared as non-contagious by provincial or local public health authorities, and I agree that neither my child nor I will participate in the Chatham-Kent Plowing Match if we are diagnosed with Covid-19 and not yet cleared as non-contagious by provincial or local public health authorities.

9(e). I do not believe that I (or my child) have been exposed to someone with a suspected and/or confirmed case of the Covid-19, and I agree that neither my child nor I will participate in the Chatham-Kent Plowing Match if I believe that I (or my child) have been exposed to someone with a suspected and/or confirmed case of Covid-19.

9(f). I (and my child) are following all public health authority recommended guidelines and limiting my/our exposure to Covid-19, and I agree that neither my child nor I will participate in the Chatham-Kent Plowing Match unless we continue to follow all public health authority recommended guidelines and limit my/our exposure to Covid-19.

必須

I have read and understood this Covid-19 Waiver and I agree to be bound by its terms. *

Yes

Please type your full name as a digital signature in confirmation that the information contained in this waiver is accurate and truthful. *

送信

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