Jacked Sports On-Line Waiver KEEP OUR COMMUNITY HEALTHY COVID-19 protocols and participant waiverJacked Sports Participant HiddenEnter the participant name Enter the participant name* First Last Phone Number*Email Address* Programs Select your team or select drop-in if you are not on a teamMonday Beach Volleyball Team- Select Below -Heather DavisMike CassAnna O'ConnorCarolyn JohnsKelly DautremontWesley O'NeillPauline McNallyTeam 8Tuesday Beach Volleyball Team- Select Below -Alicia LauwerierRob HoshowskyJeff BlignautMike HornerBill GoodaleTwylla_CurtoAshleigh ConwayTony HamiltonWednesday Beach Volleyball Team- Select Below -Laura PlaxtonBill KovacsDave AlmadelJesse De LuciaMelissa LeeJohn McTaggartJustin Da SilvaDave NormanThursday Beach Volleyball Team- Select Below -Connor ThompsonGreg MoffatSteve PatelakisMark JonesMike ChureyGurjit SinghCristi SoKait WilsonPlease check the box below if you are not on a team and joining a drop in program. No Team - Drop-In only. Please help us prevent the spread and follow these fundamental public health measures to help prevent the spread of COVID-19 If you are ill – Stay Home! If you feel ill during an activity, notify staff immediately. Keep your distance: Always keep a minimum distance of 2 metres between yourself and others (including staff and other program participants). Hygiene Considerations: Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer (more than 60% alcohol). Use alcohol-based hand sanitizer upon entering a facility. Avoid touching your eyes, nose and mouth. Cover coughs and sneezes with a tissue or sleeve. Masks/face-coverings are mandatory indoors for City facilities, in accordance with City of Burlington By-law 62-2020 as amended by By-law 64-2020. Avoid touching surfaces people touch often. The personal information collected through this form is collected under the authority of Municipal Act, 2001, S.O. 2001, c. 25. The information will be used in the event of a confirmed COVID-19 diagnosis that coincides with your visit to a sports facility or participation in a Jacked Sports program, your name and contact information may be provided to public health authorities for purposes of contact tracing. *I Understand I need to take precautions and take responsibility for my own health.*EACH AND EVERY PLAYER PARTICIPATING IN JACKED SPORTS AND SOCIAL CLUB IS REQUIRED TO READ AND AGREE TO THIS DOCUMENT. BY CLICKING THE "I AGREE" BUTTON SERVES AS PROOF THAT YOU HAVE READ AND ACCEPTED THE TERMS AND CONDITIONS OUTLINED HEREIN. YOUR REFUSAL TO AGREE TO THIS DOCUMENT PREVENTS YOUR PARTICIPATION. ACKNOWLEDGEMENT, RELEASE, INDEMNITY, AND ASSUMPTION OF RISK REGARDING COVID-19 In volleyball activities ("Activities") organized or operated by Jacked Sports I acknowledge that the World Health Organization has classified the Coronavirus Disease (“COVID-19”) outbreak as a global pandemic and am/are aware of the risks of COVID-19. I specifically acknowledge and agree that I am aware of the risks to personal health, including by the failure to follow physical distancing protocols, flowing from COVID-19, and that I am assuming, on my own behalf, all health risks and adverse health related consequences caused by or arising from engaging in any Activities (the “Assumed Risks”). I acknowledge that Jacked Sports are implementing the Provincial and Halton Region Public Health guidelines and protocols (“Protocols”). I specifically acknowledge and agree that I am are aware of Protocols, that I will abide by the Protocols, and that the Protocols are subject to all federal, provincial and municipal laws, regulations, by-laws and orders as they may exist from time to time. I hereby release Jacked Sports, their members, officers, directors, employees, independent contractors, agents, and volunteers ("Releasees") from all liability, recourse, proceedings, claims, and causes of action of any kind whatsoever, in respect of all damages, personal injuries, death, or property losses which I/we may suffer arising out of or connected with the Assumed Risks, the content or implementation of the Protocols (including without limitation the conduct of any screening of any individual), and the preparation for, or participation in, the Activities, notwithstanding that any such losses were caused solely or partly by the negligence of any of the Releasees. I do hereby agree to indemnify and hold harmless the Releasees from any and all damages or losses of any kind as a result of any and all claims, demands, causes of action of any kind whatsoever including those involving negligence on the part of any of the Releasees that may be made or initiated of my arising out of or connected with the Assumed Risks as they relate to me, the content or implementation of the Protocols as they relate to me and my preparation for and/or participation in any of the Activities. and, I/we hereby acknowledge and agree: (a) that I understand that none of the Releasees assumes any responsibility whatsoever for my safety or the safety during the course of any preparation for or participation in the aforesaid activities; (b) that I will comply with the implementation of the Protocols and that any failure on my/our part to comply with the Protocols and their implementation may have consequences (including without limitation a withdrawal to participate in an Activity or Activities) and could jeopardize relevant insurance coverage; (c) that I understand that the implementation of the Protocols may involve the collection, use and disclosure of personal information about me and I consent to same; (d) that I have carefully read this ACKNOWLEDGEMENT, RELEASE, INDEMNITY, AND ASSUMPTION OF RISK that I fully understand same, and that I am are freely and voluntarily executing same; (e) that I have been given the opportunity and that I am encouraged to seek independent legal advice prior to signing this document; (f) that I understand that the Organizers would not permit me to participate in any Activities unless I signed this ACKNOWLEDGEMENT, RELEASE, INDEMNITY, AND ASSUMPTION OF RISK, which applies to all Activities whether occurring in the near or distant future and that the terms of this document need not be brought to my attention each time I participate in a Program in order for it to be effective; (g) that the term Activities as used herein includes, without limiting the generality of that term, training sessions, camps, clinics, leagues and events. (h) that this ACKNOWLEDGEMENT, RELEASE, INDEMNITY, AND ASSUMPTION OF RISK agreement is binding on myself, my heirs, my executors, administrators, personal representatives and assigns. AGE OF MAJORITY I am at least 19 years old CONSUMPTION IS PROHIBITED: Consumption of any alcohol is strictly prohibited on site. Jacked Sports is not responsible for monitoring and controlling alcohol. ASSUMPTION OF RISKS: I am aware that participating in this activity exposes me to many inherent risks, dangers and hazards. By engaging in this activity freely accept and fully assume all inherent risk, dangers and hazards and the possibility of personal injury, death, property damage or loss resulting there from. RELEASE OF LIABILITY WAIVER OF CLAIMS & INDEMNITY AGREEMENT: On behalf of myself, members of my family, my heirs, executors, administrators and assigns, hereby forever release, discharge and hold harmless Jacked Sports, Trinity Christian School and 02437944 Ontario Inc representatives and agents for any injury, loss of damage to my person or property howsoever caused, arising out of or in connection with my taking part in Jacked Sports programs or 02437944 Ontario Inc. sports events, tournaments, leagues or programs. I read and understood this agreement prior to signing it. I am aware that my signature with waive certain legal rights which I or any heirs, next of kin, executors, administrators or assigns may have against Jacked Sports, Trinity Christian School or 02437944 Ontario Inc. and its directors, officers, employees, assigns and successors. PHOTO/IMAGE RELEASE AND WAIVER, I hereby give permission to "Jacked Sports" the right to use my photograph for marketing and communications purposes. I agree that I shall have no claim against Jacked Sports or against anyone accessing these communication products whether online, in print or by any other means. I confirm that I am over 19 years of age and that I have not given anyone the exclusive right to use my name, portrait, picture or photograph. I have read and understood this Agreement prior to accepting it. I am aware that by clicking the “approve waiver ” below, I am waiving certain legal rights which I or any heirs, next of kin, executors, administrators and assigns may have against Jacked Sports & Social Club or 02437944 Ontario Inc., Trinity Christian School and its directors, officers, employees, agents and representatives. CommentsThis field is for validation purposes and should be left unchanged.