Covid Screening

Splashville Inc. COVID-19 Liability Release Waiver

    ** Form MUST be submitted before each class
    ** Each person entering Splashville must submit the form. If entering with children, please submit a form for yourself and one for each child.
    I am filling out the form for:
    Entry Date:
    Time of Entry:
    Time of Exit:
    Dear Splashville Patrons,

    Splashville Inc. would like to thank you for your loyalty, patience, and understanding during these uncertain times. Due to the COVID-19 pandemic, please read the following waiver in release of liability. By submitting this form, you will be agreeing to the following:

    I certify that I am feeling healthy and have not exhibited any symptoms of COVID-19 within the past 14 days. I have no symptoms of fever, tiredness, dry cough, loss of taste or smell, body aches/pains, difficulty breathing, shortness of breath, nasal congestion, sore throat, and/or diarrhea;
    I certify that my child is feeling healthy and have not exhibited any symptoms of COVID-19 within the past 14 days. He/She have no symptoms of fever, tiredness, dry cough, loss of taste or smell, body aches/pains, difficulty breathing, shortness of breath, nasal congestion, sore throat, and/or diarrhea;

    I certify that I have NOT travelled to any areas outside of Ontario in the last two weeks;
    I certify that he/she has NOT travelled to any areas outside of Ontario in the last two weeks;

    I will protect myself and others by wearing a facemask while within the facility. (As a swimmer I will take off mask prior to water entry and put back on once I have exited the pool) If I DO NOT have a face mask of our own or it is deemed insufficient, I will purchase one form Splashville Inc. before entering the facility;
    He/She will protect their self and others by wearing a facemask while within the facility. (As a swimmer he/she will take off mask prior to water entry and put back on once I have exited the pool) If he/she DOES have a face mask of our own or it is deemed insufficient, I will purchase one form Splashville Inc. before entering the facility;

    I am aware that Splashville has taken all precautions and have adhered to all regulations implemented by the Ontario Ministry of Health. Employees are checked daily and sanitation occurs after every class. I waive and release Splashville Inc. and its employees from my liabilities and I will NOT seek any legal action or monetary reward for any symptoms I may have after my time at Splashville Inc;
    I agree to observe and obey all posted rules and warning and further agree to follow any oral instructions or directions given by employees of Splashville Inc.;
    I agree that MY CHILD will observe and obey all posted rules and warning and further agree to follow any oral instructions or directions given by employees of Splashville Inc.;

    I understand that Splashville Inc. reserves the right to refuse entry/service to anyone that may show signs of COVID-19;
    I certify that I am under no pressure or duress to sign this agreement and I have been given a reasonable opportunity to review this agreement before signing;
    You have answered NO to one of the screening questions. Please do not enter Splashville. Contact a health professional and stay home to self-isolate.