For the safety of all and in order to ensure the Pool will be able to continue to offer programming during the COVID pandemic, all patrons, and staff must adhere to the regulations, guidelines and direction of Municipal, Provincial, Regional and Local Health Authorities. Failing to do so will place people at risk, is contrary to the municipal code of conduct, and may result in the suspension or expulsion from the swim program.

Email Address*

Enter the participant's first and last name:*

Enter the name of the person submitting this form (enter 'self' if the participant is submitting it):*

Has the participant been diagnosed with COVID-19, or are waiting to hear the results of a lab test for COVID-19*

Yes

No

Has the participant been in contact with a suspected, probable, or confirmed case of COVID-19 within the last 14 days?*

Yes

No

Has the participant returned from outside the country within the last 14 days?*

Yes

No

Has there been indication from public health officials that the participant may have been exposed to COVID-19?*

Yes

No

Does the participant have symptoms of COVID-19, even if mild? (If no, continue to bottom of page and submit)*

Yes

No

Has the participant been in contact with or cared for someone with COVID-19 in the last 14 days?

YesNo

Does the participant have any of the following symptoms? Please select all that apply

cough

shortness of breath

chest pain

difficult breathing

fever

chills

repeated shaking will chills

abnormal muscle pain

headache

sore throat

painful swallowing

runny nose

new loss of taste or smell

gastrointestinal illness

Enter the code displayed*