APPENDIX 10: DECLARATION OF COMPLIANCE – COVID-19
Declaration of Compliance COVID-19

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Individual's Name *
Individual’s Parent/Guardian (if the individual is younger than 18 years old)
Email *
Phone Number *
Alberta Soccer Association, Foothills District Soccer Association, and Canmore Minor Soccer Club (collectively the “Organization”) require the disclosure of exposure to illness in order to safeguard the health and safety of all participants and limit the further outbreak of COVID-19. This Declaration of Compliance will be kept safely, and personal information will not be disclosed unless as required by law or with your consent. An individual (or the individual’s parent/guardian, if the individual is younger than 18 years old) who is unable to agree to the terms outlined in this document is not permitted to enter the Organization’s facilities or participate in the Organization’s activities, programs, or services.  I, the undersigned being the individual named above and the individual’s parent/guardian (if the individual is younger than 18 years old), hereby acknowledge and agree to the terms outlined in this document: *
Required
1) The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization and COVID-19 is extremely contagious. The Organization has put in place preventative measures to reduce the spread of COVID-19 and requires all individuals (or their parent/guardian, when applicable) to adhere to the compliance standards described in this document. *
Required
2) The individual has not been diagnosed with COVID-19, OR if the individual was diagnosed with COVID-19, the individual was cleared as noncontagious by provincial or local public health authorities more than 14 days prior to the date this Declaration of Compliance was signed. *
Required
3) The individual has not been exposed to a person with a confirmed or suspected case of COVID-19, OR If the individual was exposed to a person with a confirmed or suspected case of COVID-19, the date of exposure was more than 14 days prior to the date this Declaration of Compliance was signed. *
Required
4) The individual is attending or participating voluntarily and understands the risks associated with COVID-19. The individual [or the individual’s parent/guardian, on behalf of the individual (when applicable)] agrees to assume those risks, including but not limited to exposure and being infected. *
Required
5) The individual has not, nor has anyone in the individual’s household, experienced any signs or symptoms of COVID-19 in the last 14 days (including fever, new or worsening cough, fatigue, chills and body aches, sore throat, shortness of breach, respiratory illness, vomiting or diarrhea, loss of taste or smell, or difficulty breathing). *
Required
6) If the individual experiences, or if anyone in the individual’s household experiences, any cold or flulike symptoms after submitting this Declaration of Compliance, the individual will immediately isolate and not attend any of the Organization’s facilities, activities, programs or services until at least 14 days have passed since those symptoms were last experienced. *
Required
7) The individual has not, nor has any member of the individual’s household, travelled to or had a layover in any country outside Canada in the past 14 days. If the individual travels, or if anyone in the individual’s household travels outside Canada after submitting this Declaration of Compliance, the individual will not attend any of the Organization’s facilities, activities, programs or services until at least 14 days have passed since the date of return. *
Required
8) The individual is following recommended guidelines, including but not limited to, practicing physical distancing, trying to maintain separation of six feet from others, adhereing to recognized hygiene best practices, and otherwise limiting exposure to COVID-19. *
Required
9) The individual will follow the safety, physical distancing and hygiene protocols of the Organization. *
Required
10) This document will remain in effect until the Organization, per the direction of the provincial government and provincial health officials, determines that the acknowledgements in this Declaration of Compliance are no longer required. *
Required
11) The Organization may remove the individual from the facility or from participation in the activities, programs or services of the Organization at any time and for any reason if the Organization believes, in its sole discretion, that the individual is no longer in compliance with any of the compliance standards described in this document. *
Required
12. I have read and agreed to be bound by the Alberta Soccer, Foothills District Soccer Association, & Canmore Minor Soccer Club Return-to-Train Declaration of Compliance                                            
Player Signature (if 13 and older)
Parent / Guardian Signature (if younger than 13 years old)
Today's Date *
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