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Hyperfit Hockey

​159 Dynamic Drive, Toronto
Ontario, M1V5L8
Ben@Hyperfithockey.com
Tel: 416-412-0404 ext. 240
Fax: 416-412-6491

PRE-SCREENING

QUESTIONNAIRE

IMPORTANT: THIS MUST BE COMPLETED ON THE SAME DAY AS YOUR ARRIVAL TO YOUR HYPERFIT SESSION

Liability and Pre-screening Waiver For Access To Participate in Hyperfit Activities at the Georgina Ice Palace

IMPORTANT: THIS FORM MUST BE COMPLETED ON THE SAME DAY AS YOUR ARRIVAL TO THE ICE PALACE.

 

Are you currently experiencing any of these issues? If so, please call 911:

1. Severe difficulty breathing (struggling for each breath)

2. Severe Chest Pain (constant tightness or crushing sensation)

3. Feeling confused or unsure where you are

4. Losing consciousness

 

If you are in any of the following at risk groups, we ask that you speak with your physician prior to participating:

 

1. 70 years old or older

2. Getting treatment that compromises (weakens) your immune system (for example, chemotherapy, medication for transplants, corticosteroids, TNF inhibitors)

3. Having a condition that compromises (weakens) your immune system (for example, diabetes, emphysema, asthma, heart condition)

4. Regularly going to hospital or health care setting for a treatment (for example, dialysis, surgery, cancer treatment)

PLEASE READ THIS WAIVER IN ITS ENTIRETY

 

These conditions will affect your legal rights including the right to sue or claim for compensation should you contract COVID-19.  Hyperfit Hockey clients have been permitted access to the Georgina Ice Palace if they complete the pre-screening questionnaire and waiver. These forms must be submitted by any persons who desire access to Town of Georgina facilities before any use or access to Town of Georgina facilities is permitted. Individuals who have travelled outside of Canada within the previous 14 days or who are sick or who have been in contact with someone who is suspected of having COVID -19 must not access Town of Georgina arenas or use Town of Georgina facilities. This access may be withdrawn at any time based on health agency recommendations. 

Parents or court-appointed legal guardians must be 18 years of age or older and must authorize on behalf of any participating minors and agree that they and the minors are subject to all the terms of this waiver as set forth herein.

The applicant on the application/waiver and his/her parents/guardians agree that Hyperfit Hockey or the Town of Georgina, shall not be held responsible for any injury, loss or damage whatsoever occurring to the participant while he/she is in attendance at Hyperfit Hockey programs or including while he/she is within the premises occupied by Town of Georgina Arena.

I/We consent to his/her or my attendance on the terms of this waiver of liability or in the case of a guardian of a person under 19 years of age grant our consent to the terms of this waiver. I/We acknowledge reading this Application/Waiver and Declaration and understand the conditions contained herein and agree to abide by all terms. All Participants understand and consent to their duty to wear the appropriate protective gear as it applies to their sport or profession.

I would like to access the Town of Georgina facilities and/or use Town of Georgina facilities. I am aware that The Town of Georgina and Hyperfit Hockey and its staff cannot guarantee that I will not contract COVID-19 at the Town of Georgina facilities. I am accessing and using the Town of Georgina facilities at my own risk. In particular, I accept the risk of contracting COVID-19 should I attend the Town of Georgina facilities.

LET'S STAY IN TOUCH!

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159 DYNAMIC DRIVE, TORONTO, M1V 5L8 
TEL 416-412-0404  EXT. 240      •    FAX 416-412-6491     •    EMAIL BEN@HYPERFITHOCKEY.COM
© 2020 BY HYPERFIT HOCKEY 

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