Masters Aquatic Swim Programs

Thornhill Masters Aquatic Club Swim Schedule (Winter 2021 Session)

January 5, 2021 to March 25, 2021

Due to COVID 19 restrictions, swimmers will be required to sign up for a specific timeslot as per chart below. No Substitutions/Changes will be allowed once your membership for the Session is confirmed.
Swimmers must go directly to the designated area on the pool deck with mask on. Masks must be worn until you are in the water and again when you are leaving. Please bring Ziplock bag with your name on it to hold your mask.

*All Members regardless of current Membership status MUST register and pay via this form in order to participate.

Day	Timeslot	Doors Open	Swim Times	Location
Tuesday	Timeslot A	8:10pm	8:20 - 9:05 pm	Markham PAN AM Pool
Tuesday	Timeslot B	9:05pm	9:15 - 10:00pm	Markham PAN AM Pool
Thursday	Timeslot A	8:10pm	8:20 - 9:05 pm	Markham PAN AM Pool
Thursday	Timeslot B	9:05pm	9:15 - 10:00pm	Markham PAN AM Pool

Membership Information

Session: *

Name: *

Date of Birth: *

Date

Address: *

City: *

Postal Code: *

E-mail: *

Phone: *

Allergies/Illnesses/Injuries & Treatment:

OHIP Card Number: *

Emergency Contact Name: *

Emergency Contact Phone: *

Membership Fees

Winter 2021

Jan 5, 2021 to Mar 25, 2021

$300.00

Send eTransfer to ian@thornhillmultisport.com

Note: Membership will be confirmed after eTransfer is received. Given the current situation, should changes to our pool time be made at any time, this fee is non refundable.

COVID-19 Self Assessment

Every participant must complete a COVID-19 Self-Assessment before returning to training. Please go to this link for the assesssment.

https://ca.thrive.health/covid19/en

Acknowledgement *

I hereby acknowledge that I have completed the COVID-19 Self assessment.

IMPORTANT WAIVERS

The following THREE sections contain very important waivers and declarations. PLEASE READ CAREFULLY, ACKNOWLEDGE, SIGN and DATE each section.

RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT

This is a binding legal agreement. As a Participant in the sport of swimming and the programs, activities and events of the club named above (the “club”) and Masters Swimming Ontario (MSO), the undersigned acknowledges and agrees to the following:

Disclaimer I agree that the club and MSO, and their respective directors, officers, committee members, members, employees, coaches, volunteers, officials, judges, participants, agents, owners/operators of facilities, and representatives (collectively the “Organization”) are not responsible for any injury, sickness, disease including but not limited to COVID-19, damage or loss of any kind suffered by a Participant during, or as a result of, the sport of swimming or any program, activity or event, caused in any manner whatsoever including, but not limited to, the negligence of the Organization.

Assumption of Risk I am aware participation in competitive and non-competitive swimming involves many risks, dangers, and hazards, which may not be easily identified. Such risks, dangers, and hazards include, but are not limited to, an injury, Health-related problem or death resulting from:
· Exertion and stretching of various muscle groups or strenuous cardiovascular activity in or out of the water;
· Slips or falls due to uneven, slippery or irregular surfaces, including on the pool deck, in the dressing rooms or other facilities or rooms at an aquatic venue and at any physical facility in and around open water venues:
· Failure to properly use a piece of swimming-related equipment or the mechanical failure of any piece of equipment:
· Concussions or aggravated related symptoms:
· Spinal cord injuries which may result in permanent paralysis: · Travel only when it is an integral part of the Organization’s Activity;
· Infectious source such as COVID-19, as defined by the relevant municipal, provincial or federal health authorities:
· Extreme weather conditions which may result in heatstroke, sunstroke or lightning strikes: and
· Unforeseen events.

I am aware and acknowledge that:
· an injury or Health-related problem sustained can be severe and even fatal;
· the risk of injury or Health-related problem increases with fatigue and age; and
· the risk if injury or Health-related problem is reduced if the rules established for participation are followed.

I understand that I am hereby advised and solely responsible to seek medical or other competent healthcare advice with respect to my health and state of physical wellbeing with respect to the risks involved in participating in competitive and non-competitive swimming and the Organization’s sanctioned Programs. I confirm that I have not been advised by a medical doctor that my condition prevents me from participating in the Organization’s activities.

In the case of an injury or Health-related Problem, I authorize the Organization to obtain reasonably necessary on-site medical assistance, as determined in the absolute discretion of the Organization, for the medical situation, including transportation by ambulance or by other means to a hospital.

I am aware of the risks, hazards, and dangers, associated with participation in competitive and non-competitive swimming programs and Organization sanctioned Programs, and I freely and voluntary agree to assume any and all such risks.

Release of Liability In consideration of the Organization allowing me to participate, I agree:
a) To assume all risks arising out of, associated with or related to my participation;
b) To release the Organization from liability for any and all claims, demands, actions and costs that might arise out of my participating, even though such risks, injuries, loss, damage, claims, demands, actions or costs may have been caused by the negligence of the Organization.

Acknowledgement of MSO Participant Liability Waiver: *

I hereby acknowledge that I have read this agreement, that I have executed this agreement voluntarily,and that this agreement is to be binding upon myself, my heirs, executors, administrators and representatives. If this Agreement assigned electronically, I acknowledge and recognize that the electronic signature constitutes my official signature and that I am the person who completed this Agreement.

Signed: *

Clear

Date: *

Date

COVID-19 Attestation and Agreement

In consideration of being permitted to participate in the sport of swimming and the programs, activities and events of the club named above (the “club”) or Masters Swimming Ontario (MSO), the undersigned:

1. Attests and agrees to participate in activities and future activities ONLY if the participant:
a. Has not been diagnosed with COVID-19 or, if diagnosed previously, attests that the participant has been cleared as noncontagious by provincial or local public health authorities and has provided, in conjunction with this form, written confirmation from a medical doctor of the same;
b. Does not have any of the following symptoms: cough, shortness of breath, chest pain, difficulty breathing, fever, chills, repeated shaking with chills, abnormal muscle pain, headache, sore throat, painful swallowing, runny nose, new loss of taste or smell, and/or gastrointestinal illness;
c. Has not been in contact with or cared for someone with COVID-19 in the last 14 days; and
d. Has not returned from a trip outside the country within the last 14 days.

2. Agrees that the participant:
a. Will immediately advise if the statements made on this form are no longer accurate as a result of a COVID-19 diagnosis, onset of symptoms, contact being made with someone with COVID-19 or travel outside of the country;
b. Has reviewed and will follow the return to swimming procedures issued by their club (named above); and
c. Will follow the laws, recommended guidelines, and protocols issued by their 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 activity.

3. Agrees and accepts the risks that:
a. By participating in the activity, the participant assumes the risk of contracting COVID-19 and/or transmitting it to others and voluntarily accepts that risk.

Acknowledgement of COVID-19 Attestation and Agreement (MSO) *

I hereby acknowledge that I have read this Attestation and Agreement, that I voluntarily attest and agree to all statements.

Signed: *

Clear

Date: *

Date

Personal Information Protection & Electronic Documents Act

The Canadian Personal Information Protection & Electronic Documents Act (and equivalent provincial legislation) requires that consent be obtained prior to the collection and use of all personal information.
The personal information you provide through this registration will be used for the purposes reasonably associated with the swimming activities conducted by the club named above (the “club”) and, as the case may be, Canadian Independent Masters Swimming (CIMS), Masters Swimming Manitoba (MSM) or Masters Swimming Ontario (MSO) (the “Organization”),. These purposes include event registration, insurance coverage, training and competition participation and competition result publication.
The information you provide is for purposes including registration, insurance coverage and:
a) Ensuring swimmers compete in the appropriate age group;
b) Reporting non-identifying, demographic and participation statistics for club and planning and policy purposes;
c) Reporting and publishing athletes’ name, gender, age, club affiliation on the Organization’s website or in results, news releases and ranking reports and;
d) Making direct contact with the registrant as necessary for the operations of the Club and the Organization.
The Organization does not release personal information to third parties.
Should a registrant wish to review their personal information held by the Club or the Organization, they must make a request to the respective organization. Further, registrants may withdraw consent to use their personal information. Such a withdrawal however, may require the cancellation of registration with and suspension of activities with the Club and/or the Organization. All registrants must sign a copy of this form each season.

Acknowledgement of Consent to collect personal information

I hereby consent to the collection and use of personal information as described above.

Signed: *

Clear

Date: *

Date