COVID-19 Agreement and Attestation

COVID-19 ATTESTATION AND AGREEMENT

By signing below, the participant (named below) or the participant’s Guardian attests that the they:&#13;&#10;&#13;&#10;1. Do not knowingly have COVID-19;&#13;&#10;2. Are not experiencing any known symptoms of COVID-19, such as fever, cough, shortness of breath or malaise.&#13;&#10;3. Have not travelled internationally during the past 14 days;&#13;&#10;4. Have not frequented a COVID-19 high risk area in the Province/Territory during the last 14 days;&#13;&#10;5. Have not, in the past 14 days, knowingly come into contact with someone who has COVID-19, who has known symptoms of COVID-19 or is self-quarantining after returning to Canada; and,&#13;&#10;6. Have been following government recommended guidelines in respect of COVID-19, including practicing physical distancing.&#13;&#10;&#13;&#10;Furthermore, by signing below, the participant agrees that while attending the Fiddler's Green Stables or attending an event at the facility, they:&#13;&#10;&#13;&#10;1. Will 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 their ability while attending Fiddler's Green Stables or attending an event at the facility;&#13;&#10;2. Will follow the guidelines and protocols mandated by Fiddler's Green Stables in respect of COVID-19;&#13;&#10;3. Will, in the event that that they experience any symptoms of illness such as a fever, cough, difficulty breathing, shortness of breath or malaise, immediately:&#13;&#10;Inform the competition organizer; and,&#13;&#10;Depart from the facility immediately.

Participant Name *

First Name Middle Name Last Name

Birth Date *

Month Day Year

Gender

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Guardian Name (if the participant is a minor) *

First Name Last Name

Signature *

Clear

Date *

Date