M2 Dance Company Covid -19 Liability Form
May 19, 2024 11:55 PM
M2 Dance Company Covid-19 Liability Form
Liability Form for: _________________________________________ (Dancers Name):
In this Liability, “Team Member” includes an employee, volunteer, participant, or parent/guardian.
1. Inform an individual in a position of authority (M2 Teachers/Owners ) immediately if, you feel any symptoms of COVID-19 such as fever,
chills, cough, shortness of breath, sore throat and painful swallowing, stuffy or runny nose, loss of sense of smell, headache, muscle aches,
fatigue and loss of appetite.
2. Assessment
a. Team members must review the self-assessment signage located throughout the facility each morning before their
shift/practice/activity to attest that they are not feeling any of the COVID 19 symptoms.
b. M2 Teachers will visually monitor team members to assess any early warning signs as to the status of their health and to
touch base on how they are regarding their personal safety throughout the workday/practice/activity.
c.If Team Members are unsure please have them use the self-assessment tool or through the COVID-19
https://myhealth.alberta.ca/Journey/COVID-19/Pages/COVID-Self-Assessment.aspx Support App self assessment tool.
3. If a Team Member is feeling sick with COVID-19 symptoms
a. They should remain at home and contact Alberta Health at 8-1-1.
b. If they feel sick and /or are showing symptoms while at work, they should be sent home immediately and have them contact 8-1-1
or a doctor for further guidance.
c. No Team Member may participate in a practice/activity if they are symptomatic.
4. If a Team Member tests positive for COVID-19
a. The Team Member will not be permitted to return to the workplace/practice/studio until they are free of the COVID-19 virus.
b. Any Team Members who work/play closely with the infected Team Member will also be removed from the
workplace/practice/studio for at least 14 days to ensure the infection does not spread further.
c. Close off, clean and disinfect their work/practice/studio area immediately and any surfaces that could have potentially be
infected/touched.
5. If a Team Member has been tested and is waiting for the results of a COVID-19 Test
a. As with the confirmed case, the Team Member must be removed from the workplace/practice/studio.
b. The Public Health Agency of Canada advises that any person who has even mild symptoms to stay home and call the public health
authority of Alberta
c. Other Team Members who may have been exposed will be informed and removed from the workplace/practice/studio for at least
14 days or until the diagnosis of COVID-19 is ruled out by health authorities.
d. The workspace/practice/studio space will be closed off, cleaned, and disinfected immediately and any other surfaces that could
have potentially been infected/touched.
6. If a Team Member has come in to contact with someone who is confirmed to have COVID-19:
a. Team Members must advise their employer/coach if they reasonably believe they have been exposed to COVID-19.
b. Once the contact is confirmed, the Team Member will be removed from the workplace/practice/studio for at least 14 days or as
otherwise directed by public health authorities. Team Members who may have come into close contact with the Team Member will
also be removed from the workplace for at least 14 days.
c. The workspace/studio area will be closed off, cleaned, and disinfected immediately and any other surfaces that could have
potentially been infected/touched.
7. Quarantine or Self-Isolate if:
a. Any Team Member who has travelled outside of Canada or the province within the last 14 days is not permitted to enter any
part of the facility and must quarantine and self-isolate.
b. Any Team Member with any symptoms of COVID-19 is not permitted to enter any part of the studio and must quarantine and
self-isolate.
c. Any Team Member from a household with someone showing symptoms of COVID-19 is not permitted to enter any part of the
studio and must quarantine and self-isolate.
d. Any Team Member who is in quarantine or self-isolating because of contact with an infected person or in families who are selfisolating, is not permitted to enter any part of the studio.
8. Assumption of Risk of Contracting Covid-19:
In consideration of being allowed to participate in any way in the M2 Dance Company, related events and activities, I (being said participant
and/or parent or legal guardian with legal responsibility for this participant of minority age) acknowledge, appreciate and agree that:
1. The risk of Contracting Covid-19 from the activities in this program is significant, and while particular rules, screening, physically distancing,
masks and cleaning protocol may reduce this risk, the risk for Contracting Covid-19 does exist; and,
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or other, and assume full responsibility for my participation; and,
3. I willingly agree to comply with the stated and customary terms and conditions for participation.
I, _____________________ (NAME OF PARENT/GUARDIAN) HAVE READ AND UNDERSTAND THE ABOVE POLICIES AND PROCEDURES OUTLINED IN THE ABOVE COVID-19 LIABILITY FORM. I ACCEPT THESE TERMS AND CONDITIONS.
Signature parent/guardian: _______________________________Date: _______________________