COVID-19 Declaration Form

COVID-19 Waiver

The Calgary Rosedale Community Association COVID-19 Rules and Community Hall Declarations

The Calgary Rosedale Community Association and Fun 'n' Dance Ltd. COVID-19 Rules and Community Hall Declarations

Declaration Form Status *

ADULT (18+) DAILY QUESTIONS

The questions below are based on the Alberta COVID-19 Health Questions for persons over 18.
Access Questions (Opens in a new window)

CHILD (BELOW 18) DAILY QUESTIONS

The questions below are based on the Alberta COVID-19 Health Questions for persons over 18.
Access Questions (Opens in a new window)

Please spell out your full name. The fields that follow are your child's name and details.

Summary

This declaration must be completed prior to visiting the Calgary Rosedale Community Association Facilities. Failure to do so prior will result in denial of access to the facilities.

The Calgary Rosedale Community Association appreciates and expects your cooperation to allow us to re-open the community hall. We are asking that you strictly observe our rules during COVID-19. The Calgary Rosedale Community Association is permitting use based on your assurances within this document. Any false statements could result in legal liability towards you. You agree to observe and fully abide by all rules and regulations as described in the Calgary Rosedale Community Association COVID-19 Relaunch Plan. You may be asked to leave the premises if you are not abiding by said rules and regulations.

The virus can be transmitted by asymptomatic people. The Calgary Rosedale Community Association is following government rules and regulations but there can be no assurance that the virus will not be contracted at our facilities. Please understand that you are taking part in this program or activity at your own risk.

By completing and submitting this declaration you agree to the statements within:

This declaration must be completed prior to visiting the Calgary Rosedale Community Association Facilities to attend Fun 'n' Dance Ltd. classes. Failure to do so prior will result in denial of access to the facilities.

Fun'n'Dance Ltd. and the Calgary Rosedale Community Association appreciates and expects your cooperation to allow us to re-open the community hall. We are asking that you strictly observe our rules during COVID-19. Fun'n'Dance Ltd. and The Calgary Rosedale Community Association is permitting use based on your assurances within this document. Any false statements could result in legal liability towards you. You agree to observe and fully abide by all rules and regulations as described in the Calgary Rosedale Community Association COVID-19 Relaunch Plan. You may be asked to leave the premises if you are not abiding by said rules and regulations.

The virus can be transmitted by asymptomatic people. Fun'n'Dance Ltd. and The Calgary Rosedale Community Association is following government rules and regulations but there can be no assurance that the virus will not be contracted at our facilities. Please understand that you are taking part in this program or activity at your own risk.

By completing and submitting this declaration you agree to the statements within:

Personal Information

Your name, unless you are filling this out on behalf of a child - then you should use their name.

Declarations - Adult

I hereby declare that I, or anyone I have had close contact with, am not infected with the COVID-19 virus. If I, or anyone I have had close contact with, were infected previously, I declare that all have been deemed recovered by Alberta Health Services (AHS) and are not a risk of spreading the virus. *
Alberta Health Services (AHS) states that you are legally required to isolate for a minimum of 10 days if you have a cough, fever, shortness of breath, runny nose, or sore throat that is not related to a pre-existing illness or health condition. I hereby declare that I, or anyone I have had close contact with, am not required to isolate at this time. *
I hereby declare that I, or anyone I have had close contact with, have not travelled to or had a lay-over in any country outside Canada in the past 14 days. *
I have read and understand the Calgary Rosedale Community Association COVID-19 Relaunch Plan rules and accept and waive any right to privileges should I not comply with these rules. *
I hereby accept the RISK OF CONTRACTING COVID-19 by choosing to attend or use the Calgary Rosedale Community Association facilities. *
I hereby release the Calgary Rosedale Community Association, its Directors, Officers and Staff from any and all claims that I have or may have in the future for:
a. any loss or damage the I may suffer due to contracting COVID-19, including sickness or death, as a result of attending or using the facilities; and
b. any requests to leave the premises as imposed by the Calgary Rosedale Community Association resulting from the breach of my obligations under this “Agreement”. * *
I hereby release the Calgary Rosedale Community Association, its Directors, Officers and Staff, and Fun 'n' Dance Ltd., its Directors, Officers, and Staff from any and all claims that I have or may have in the future for:
a. any loss or damage the I may suffer due to contracting COVID-19, including sickness or death, as a result of attending or using the facilities; and
b. any requests to leave the premises as imposed by the Calgary Rosedale Community Association or Fun 'n' Dance Ltd. resulting from the breach of my obligations under this “Agreement”. *

Declarations - Child

I hereby declare that I, or anyone I have had close contact with, have not travelled to or had a lay-over in any country outside Canada in the past 14 days. *
I hereby declare that I, or anyone I have had close contact with, am not infected with the COVID-19 virus. If I, or anyone I have had close contact with, were infected previously, I declare that all have been deemed recovered by Alberta Health Services (AHS) and are not a risk of spreading the virus. *
I have reviewed the AHS COVID-19 Alberta Health Daily Checklist (click to open - opens in a new tab) and declare that my child is not required to isolate nor are they required to stay home and be monitored. *
I have read and understand the Calgary Rosedale Community Association COVID-19 Relaunch Plan rules and accept and waive any right to privileges should I not comply with these rules. *
I hereby accept the RISK OF CONTRACTING COVID-19 by choosing to attend or use the Calgary Rosedale Community Association facilities. *
I hereby release the Calgary Rosedale Community Association, its Directors, Officers and Staff from any and all claims that I have or may have in the future for:
a. any loss or damage the I may suffer due to contracting COVID-19, including sickness or death, as a result of attending or using the facilities; and
b. any requests to leave the premises as imposed by the Calgary Rosedale Community Association resulting from the breach of my obligations under this “Agreement”. * *
I hereby release the Calgary Rosedale Community Association, its Directors, Officers and Staff, and Fun 'n' Dance Ltd., its Directors, Officers, and Staff from any and all claims that I have or may have in the future for:
a. any loss or damage the I may suffer due to contracting COVID-19, including sickness or death, as a result of attending or using the facilities; and
b. any requests to leave the premises as imposed by the Calgary Rosedale Community Association or Fun 'n' Dance Ltd. resulting from the breach of my obligations under this “Agreement”. *