MAWA Daily Attestation

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To comply with our Return to Wrestling protocols, this form must be completed before EACH practice.

If athlete is under 18, the PARENT MUST COMPLETE THIS FORM

Email *

Participant's Full Name *

Parent/Guardian (if under 18) Full Name *

Contact Number (**If under 18 please provide PARENT CELL NUMBER) *

Today's Date *

YYYY

Practice Location *

Are you experiencing any known symptoms of COVID-19? Such as fever/chills, cough, shortness of breath, sore throat, runny or congested nose, sore throat, headache? *

Yes

Have you returned from travel outside of Canada in the past 14 days? *

Yes

Have you been in close contact with someone who has travelled outside of Canada in the past 14 days? *

Yes

Have you knowingly come into contact with someone who has COVID-19 in the past 14 days? *

Yes

Have you been advised to self-isolate or be quarantined due to exposure to possible exposure to COVID-19? *

Yes

By completing this form the Participant or the Participant’s Guardian agrees that while attending or participating in the Organization's events or attending at the Organization’s facilities, the Participant will: *

1. Follow the laws, recommended guidelines, and protocols issued by the Government of the Province in respect of COVID-19, including practicing physical distancing, and will do so to the best of the Participant’s ability while participating in the Organization's events or attending at the Organization’s facilities

2. Follow the guidelines and protocols mandated by the Organization in respect of COVID-19

3. In the event that the Participant experiences any symptoms of illness such as a fever, cough, difficulty breathing, shortness of breath or malaise, immediately: a. inform a representative of the Organization; and b. depart from the event or facility.

Required

SIGNATURE By checking the box below, this serves as a signature for either the participant or parent/guardian (if under 18) *

I attest that the above is true and that I have read the COVID guidelines and restrictions. By checking this box, I understand that it serves as my signature.

Required

A copy of your responses will be emailed to the address you provided.

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