BLUE DEVILS FC
Please make sure to read both Form 1 and Form 2, sign and submit.
DECLARATION OF COMPLIANCE – COVID-19 STAGE 3
ALL INDIVIDUALS ENTERING THE FACILITY AND/OR PARTICIPATING IN SANCTIONED ACTIVITIES MUST COMPLY WITH THIS DECLARATION
Ontario Soccer and its affiliated districts, leagues, clubs and teams (collectively the “Organization”) require the disclosure of exposure or illness is in order to safeguard the health and safety of all participants and limit the further spread of COVID-19. This Declaration of Compliance will be kept safely, and personal information will not be disclosed unless as required by law or with your consent.
An individual (or the individual’s parent/guardian, if the individual is younger than 18 years old) who is unable to agree to the terms outlined in this document is not permitted to enter the Organization’s facilities or participate in the Organization’s activities, programs, or services.
I, the undersigned being the individual named above and the individual’s parent/guardian (if the individual is younger than 18 years old), hereby acknowledge and agree to the terms outlined in this document:
- The coronavirus disease COVID-19 has been declared a worldwide pandemic by the World Health Organization and COVID-19 is extremely contagious. The Organization has put in place preventative measures to reduce the spread of COVID-19 and requires all individuals (or their parent/guardian,when applicable) to adhere to the compliance standards described in this document.
- The individual has not been diagnosed with COVID-19. OR If the individual was diagnosed with COVID-19, the individual was cleared as non contagious by provincial or local public health authorities.
- If the individual is a front-line worker (such as hospital staff, long term care staff, or other individual who interacts with individuals who have confirmed or suspected cases of COVID-19), the individual has worn proper and approved Personal Protective Equipment at all times whenever they interacted with an individual who has a confirmed or suspected case of COVID-19 in the last 14 days.
- If the individual is not a front-line worker, or other individual who interacts with individuals who have confirmed or suspected cases of COVID-19, they have not been exposed to a person with a confirmed or suspected case of COVID-19 in the last 14 days.
- The individual is attending or participating voluntarily and understands the risks associated withCOVID-19. The individual (or the individual’s parent/guardian, on behalf of the individual (when applicable)) agrees to assume those risks, including but not limited to exposure and being infected.
- The individual has not, nor has anyone in the individual’s household, experienced any signs or symptoms of COVID-19 in the last 14 days (including fever, new or worsening cough, fatigue, chills and body aches, respiratory illness, difficulty breathing, nausea, vomiting or diarrhea, pink eye, or loss of taste or smell).
- If the individual experiences, or if anyone in the individual’s household experiences, any signs or symptoms of COVID-19 after submitting this Declaration of Compliance, the individual will immediately isolate, notify the Organization, and not attend any of the Organization’s facilities, activities, programs or services until at least 14 days have passed since those symptoms were last experienced.
- The individual is not currently under quarantine or required to isolate, as per a directive from the federal, provincial, or local government, or because of any other reason.
- The individual is following recommended guidelines, including but not limited to, practicing physical distancing, trying to maintain separation of six feet from others, adhering to recognized hygiene best practices, and otherwise limiting exposure to COVID-19.
- The individual will follow the safety, physical distancing and hygiene protocols of the Organization.
- The individual will bring their own personal items and personal equipment (such as water bottles, bags, towels, etc.) at their discretion and will not share their personal items or equipment with other individuals.
- This document will remain in effect until the Organization, per the direction of the provincial government and provincial health officials, determines that the acknowledgements in this Declaration of Compliance are no longer required.
- The Organization may remove the individual from the facility or from participation in the activities, programs or services of the Organization at any time and for any reason if the Organization believes, in its sole discretion, that the individual is no longer in compliance with any of the standards described in this document.
INFORMED CONSENT AND ASSUMPTION OF RISK AGREEMENT
(To be executed by Participants under the age of majority UNDER 18)
WARNING! By signing this document, you will assume certain risk and responsibilities. Please read carefully!
- This is a binding legal agreement. Clarify any questions or concerns before signing. As a Participant in activities,programs, classes, services provided and events sponsored or organized by Ontario Soccer and its affiliated districts, leagues, clubs, academies and teams (collectively the “Organization”) and the sport of soccer, including but not limited to: games, tournaments, practices, training, personal training, dry land training, use of strength training and fitness conditioning equipment, machines and facilities, nutritional and dietary programs, orientationalor instructional sessions or lessons, aerobic and anaerobic conditioning programs (collectively the “Activities”), the undersigned being the Participant and Participant’s Parent/Guardian (collectively the “Parties”) acknowledges and agrees to the following terms outlined in this agreement:
- I am the Parent/Guardian of the Participant and have full legal responsibility for the decisions of the Participant.
Description of Risks
- The Parties understand and acknowledge that:a) The Activities have foreseeable and unforeseeable inherent risks, hazards and dangers that no amount of care, caution or expertise can eliminate, including without limitation, the potential for serious bodily injury,permanent disability, paralysis and loss of life;b) The Organization may offer or promote online programming (such as webinars, remote conferences,workshops, and online training) which have different foreseeable and unforeseeable risks than in-person programming;c) The Organization has a difficult task to ensure safety and it is not infallible. The Organization may be unaware of the Participant’s fitness or abilities, may give incomplete warnings or instructions, may misjudge weather or environmental conditions, and the equipment being used might malfunction; andd) The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization and COVID-19 is extremely contagious. The Organization has put in place preventative measures to reduce the spread of COVID-19; however, the Organization cannot guarantee that the Participant will not become infected with COVID-19. Further, attending the Activities could increase your risk of contracting COVID-19.
- The Participant is participating voluntarily in the Activities. In consideration of that participation, the Parties hereby acknowledge that they are aware of the risks, dangers and hazards and may be exposed to such risks,dangers and hazards. The risks, dangers and hazards include, but are not limited to:a) Contracting COVID-19 or any other contagious disease;b) Executing strenuous and demanding physical techniques;c) Vigorous physical exertion, strenuous cardiovascular workouts and rapid movements;d) Exerting and stretching various muscle groups;e) The failure to properly use any piece of equipment or from the mechanical failure of any piece of equipment;f) Spinal cord injuries which may render the Participant permanently paralyzed;g) Serious injury to virtually all bones, joints, ligaments, muscles, tendons and other aspects of the Participant’s body or to the Participant’s general health and well-being;h) Abrasions, sprains, strains, fractures, or dislocations;i) Concussion or other head injuries, including but not limited to, closed head injury or blunt head trauma;j) Physical contact with other participants, spectators, equipment, and hazards;k) Not wearing appropriate safety or protective equipment, such a helmet;l) Failure to act safely or within the Participant’s ability or within designated areas;m) Grass, turf, and other surfaces including bacterial infections and rashes;n) Collisions with fences, poles, stands, and soccer equipment;o) Negligence of other persons, including other spectators, participants, or employees;p) Weather conditions; andq) Travel to and from competitive events and associated non-competitive events which are an integral part of the Activities
- In consideration of the Organization allowing the Participant to participate in the Activities, the Parties agree:
a) That the Participant’s mental and physical condition is appropriate to participate in the Activities;
b) That when the Participant practices or train in his or her own space, the Parties are responsible for the Participant’s surroundings and the location and equipment that is selected for the Participant;
c) To comply with the rules and regulations for participation in the Activities;
d) To comply with the rules of the facility or equipment;
e) That if the Participant observes an unusual significant hazard or risk, the Participant will remove themselves from participation and bring such to the attention of an Organization representative immediately;
f) The risks associated with the Activities are increased when the Participant is impaired and the Participant agrees not to participate if impaired in any way;
g) That it is their sole responsibility to assess whether any Activities are too difficult for the Participant. By the Participant commencing an Activity, they acknowledge and accept the suitability and conditions of the Activity;
h) That they are responsible for the choice of the Participant’s protective equipment and the secure fitting of the protective equipment;
i) That COVID-19 is contagious in nature and the Participant may be exposed to or infected by COVID-19 and such exposure may result in personal injury, illness, permanent disability or death and voluntarily agree to assume all of the foregoing risks.
In consideration of the Organization allowing the Participant to participate, the Parties agree:
a) That the Parties are not relying on any oral or written statements made by the Organization or their agents, whether in brochure or advertisement or in individual conversations, to agree to be involved in the Activities; and
b) That the Organization is not responsible or liable for any damage to the Participant’s vehicle, property, or equipment that may occur as a result of the Activities.
The Parties agree that in the event that they file a lawsuit against the Organization, they agree to do so solely in the province of Ontario, Canada and they further agree that the substantive law of Ontario will apply without regard to conflict of law rules.
The Parties expressly agree that this Agreement is intended to be as broad and inclusive as is permitted by law and that if any of its provisions are held to be invalid, the balance shall, notwithstanding, continue in full legal force and effect.
CONSENT FOR MEDICAL TREATMENT
In the event that my child is injured or ill, I hereby give consent to medical personnel to administer medical treatment to my child including medical and surgical services including x-ray, anesthesia and drugs as deemed necessary for the safety and welfare of my child. I authorize the information on this form to be released to all medical personnel and any other necessary parties. I understand that it is my responsibility to advise the coaching staff and management immediately if there is any change to the above information.
CONSENT FOR USE OF PERSONAL INFORMATION
I, the Participant and/or the Parent/Guardian of the Participant
1. Authorize the Blue Devils Academy, the Canadian Soccer Association, the Ontario Soccer Association and District Leagues, (collectively the “Organizations”) to collect and use personal information about the Participant for the purpose of receiving communications and the purposes described in the Organizations respective Privacy Policies.
2. Grant permission to the Organizations and anyone authorized by them, permission to use the Participant’s name, likeness, image, voice, appearance and/or performance whether recorded on or transferred to videotape, film, slides, photographs, audio tapes, digital media, or other media, now known or later developed.
3. Authorize the inclusion of the Participant in photographs and video and understand that this media will be used on the Blue Devils Academy’s website, social media, hosted photo galleries and other sites related sites. Photos and videos may also be taken at any time for print or online promotional purposes but participants will not be identified.
4. Understand that such consent may be withdrawn at any time by sending an email to firstname.lastname@example.org.
The Parties acknowledge that they have read this agreement and understand it, that they have executed this agreement voluntarily, and that this Agreement is to be binding upon themselves, their heirs, their spouses, parents, guardians, next of kin, executors, administrators and legal or personal representatives.