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):*

Does the participant have any of the following symptoms that are new, worsening or not related to other known conditions?*

Cough

barking cough or difficulty breathing

Fever or Chills

Pink eye

Sore throat or trouble swallowing

Loss of taste or smell

Runny or congested nose

Headache/extremely tired or muscle aches/falling down

Nausea/vomitting or diarrhea

None of the above

In the last 14 days, has the participant:*

Travelled outside of Canada

Been identified as a 'close contact' of someone who currently has COVID-19

Received a COVID Alert exposure notification on your cell phone

None

Has a doctor, health care provider, or public health unit told the participant that you should currently be isolating (staying home)?*

Yes

No

Enter the code displayed*