Name *

First Name

Last Name

Screening *

I acknowledge that not I , nor anyone in my party, are experiencing any of the following symptoms: - Cough/Cold/Flu-like Symptoms - Fever - Unexplained Shortness of Breath - Any other COVID-19 Symptoms I acknowledge that not I, nor anyone in my party: - Are awaiting the results of COVID-19 testing. - Have been advised to self-isolate at this time.

I have read, understand and agree with the statements above. These statements are true to the best of my knowledge.

Consent *

I agree that I am participating in this event by my own free-will. I understand the risk of transmission of COVID-19 is very low, and that Picture Muskoka (Lindsay Fay) has taken great steps to ensure the safety of all participants of this event. I relieve Picture Muskoka (Lindsay Fay) of any responsibility or liability should I contact COVID-19. I agree to participate in this event knowing the risk of transmission is very low, but still possible.

I have read, understood and agree.