Innisfil Facility Check-in Form
This form must be filled out for
EVERY PERSON
entering an Innisfil Public Facility for
any purpose
and for
any length of time.
The form must be:
filled out on the
same calendar day
as you will be in the building, and
done
before entering the facility
.
For more information, please see the Town's
Return to Play Protocol: Arenas
.
Please note effective immediately no spectators will be permitted in our arenas (exception for 1 parent/guardian supervision of children (U14 teams and below)).
PLEASE NOTE:
EVERYONE must wear a face covering while in Town of Innisfil facilities (some exceptions apply - see the
Town's Face Covering Policy CP.1.1.11
for more information)
First Name
*
Last Name
*
Phone (10 digits)
*
Email (optional)
Please check if you are a minor below the age of 18
Parent/Guardian First Name
Parent/Guardian Last Name
Parent/Guardian Phone
Location(s) Attending
*
-- Select a Location --
Innisfil Recreation Centre (IRC)
Lefroy Arena Ice Rink
Lefroy Arena Banquet Hall
Stroud Arena - Slab
Stroud Arena - Banquet Hall
Churchill Community Centre
Cookstown Library and C.C,
Knock Community Hall
Rizzardo Health and Wellness Centre
Activity Start Time
*
-- Select a Time --
7:00 AM
7:15 AM
7:30 AM
7:45 AM
8:00 AM
8:15 AM
8:30 AM
8:45 AM
9:00 AM
9:15 AM
9:30 AM
9:45 AM
10:00 AM
10:15 AM
10:30 AM
10:45 AM
11:00 AM
11:15 AM
11:30 AM
11:45 AM
12:00 PM
12:15 PM
12:30 PM
12:45 PM
1:00 PM
1:15 PM
1:30 PM
1:45 PM
2:00 PM
2:15 PM
2:30 PM
2:45 PM
3:00 PM
3:15 PM
3:30 PM
3:45 PM
4:00 PM
4:15 PM
4:30 PM
4:45 PM
5:00 PM
5:15 PM
5:30 PM
5:45 PM
6:00 PM
6:15 PM
6:30 PM
6:45 PM
7:00 PM
7:15 PM
7:30 PM
7:45 PM
8:00 PM
8:15 PM
8:30 PM
8:45 PM
9:00 PM
9:15 PM
9:30 PM
9:45 PM
10:00 PM
10:15 PM
10:30 PM
Attendees Role
*
Player / Participant
Coaches and Trainers
League Official (Including Timekeepers and Referees)
Parent / Guardian
Other
please type in Role:
League
*
Barrie AAA Zone
Barrie and District Ringette Association
Barrie Christian Hockey League
Barrie Mens Hockey League (aka Ontario Sports Management)
Barrie Royal Blades Synchronized Skating
Barrie Womens Hockey Association
Big Bay Safe Hockey League
Bob Mashinter Group
Essa Hockey
Innisfil Co-Ed Adult Broomball League
Innisfil Fire
Innisfil Gentlemens Hockey League
Innisfil Junior Broomball League
Innisfil Minor Hockey
Innisfil SnowDogs
Lefroy Minor Hockey
Lefroy Skating Club
Ontario Sports Management (aka Barrie Mens Hockey League)
Patrick Arbour Sports
PLC Sports
Rusty Blades
South Simcoe Hockey School
Stroud Mens Hockey League
Other
please type in league:
COVID-19 SCREENING QUESTIONNAIRE
Please verify that none of the following apply:
In the last 14 days, have you had close physical contact with someone who tested positive for COVID-19? This includes receiving a COVID Alert exposure notification.
NOTE:
"Close physical contact" means being less than 2 metres away in the same room, workspace, or area or living in the same home.
In the last 14 days, have you had close physical contact with someone who returned from outside of Canada in the last 2 weeks?
Have you travelled outside of Canada in the last 14 days?
Do you have any of the following symptoms: fever, new onset of cough, worsening chronic cough, shortness of breath, difficulty breathing, sore throat, difficulty swallowing, decrease or loss of sense of taste or smell, chills, headaches, unexplained fatigue/malaise/muscle aches (myalgias), nausea/vomiting, diarrhea, abdominal pain, pink eye (conjunctivitis), runny nose/nasal congestion without other known cause, and if you're over 70: delirium, unexplained or increased number of falls, acute functional decline, worsening of chronic conditions?
If you answered YES to ANY COVID-19 screening questions, you are NOT permitted to enter the facility. You should visit a
COVID-19 Assessment Centre
or contact your health care provider for follow up.
I agree that I have answered NO to all of the covid-screening questions and that to the best of my knowledge, myself and/or the minor on whose behalf I am signing, do not have COVID-19.
I have read and understood the above, and I confirm that my above answers are true to the best of my knowledge and ability. By clicking here, I understand that I am applying my digital signature.
(Please only click once and wait)
Personal Information collected through this page is collected, retained and disclosed in accordance with the Municipal Freedom of Information and Protection of Privacy Act for the purposes of Contact Tracing and Active Screening as required by provincial regulation and the advice of our public health officials. It may be disclosed to the Town, and/or public health officials in the event of an outbreak or suspected outbreak of COVID-19. It will be retained for 60 days, or longer in the event of an outbreak, suspected outbreak, or upon the advice and/or direction of the province or public health officials. For more information about this collection please contact
The Town of Innisfil
.