R21, 2021-02-23

NOTE: Whynot Adventure does not accept paper waivers, please submit electronically.

Pre-Trip/Rental Declaration of Health and Exposure

Whynot Adventure takes the safety of our guests and team seriously, and the prevention of the spread of the COVID-19 pandemic very seriously. As such, you are required to make five attestations below for yourself and/or your child. The inability to make one or more of these attestations may disqualify you and/or your child from participating. 

Please select who will be participating:

First Minor's Information


I, the undersigned, attest to the following: (please  tick the box beside each applicable attestation). In the case of a minor, "I" refers to that minor.

To the best of my knowledge, I do not have the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19, nor have I had it within the past 14 days

Select this box if you agree with the above statement

To the best of my knowledge, I have not been exposed to someone who has the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19 within the past 14 days

Select this box if you agree with the above statement

Within the past 14 days, I have not experienced any of the following that are new and not related to allergies or pre-existing conditions: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose

Select this box if you agree with the above statement

To the best of my knowledge, within the past 14 days, I have not been exposed to someone who expressed any of the following symptoms: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose

Select this box if you agree with the above statement

I have not travelled outside Nova Scotia during the past 14 days

Select this box if you agree with the above statement

Second Minor's Information


I, the undersigned, attest to the following: (please  tick the box beside each applicable attestation). In the case of a minor, "I" refers to that minor.

To the best of my knowledge, I do not have the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19, nor have I had it within the past 14 days

Select this box if you agree with the above statement

To the best of my knowledge, I have not been exposed to someone who has the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19 within the past 14 days

Select this box if you agree with the above statement

Within the past 14 days, I have not experienced any of the following that are new and not related to allergies or pre-existing conditions: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose

Select this box if you agree with the above statement

To the best of my knowledge, within the past 14 days, I have not been exposed to someone who expressed any of the following symptoms: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose

Select this box if you agree with the above statement

I have not travelled outside Nova Scotia during the past 14 days

Select this box if you agree with the above statement

Third Minor's Information


I, the undersigned, attest to the following: (please  tick the box beside each applicable attestation). In the case of a minor, "I" refers to that minor.

To the best of my knowledge, I do not have the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19, nor have I had it within the past 14 days

Select this box if you agree with the above statement

To the best of my knowledge, I have not been exposed to someone who has the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19 within the past 14 days

Select this box if you agree with the above statement

Within the past 14 days, I have not experienced any of the following that are new and not related to allergies or pre-existing conditions: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose

Select this box if you agree with the above statement

To the best of my knowledge, within the past 14 days, I have not been exposed to someone who expressed any of the following symptoms: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose

Select this box if you agree with the above statement

I have not travelled outside Nova Scotia during the past 14 days

Select this box if you agree with the above statement

Fourth Minor's Information


I, the undersigned, attest to the following: (please  tick the box beside each applicable attestation). In the case of a minor, "I" refers to that minor.

To the best of my knowledge, I do not have the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19, nor have I had it within the past 14 days

Select this box if you agree with the above statement

To the best of my knowledge, I have not been exposed to someone who has the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19 within the past 14 days

Select this box if you agree with the above statement

Within the past 14 days, I have not experienced any of the following that are new and not related to allergies or pre-existing conditions: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose

Select this box if you agree with the above statement

To the best of my knowledge, within the past 14 days, I have not been exposed to someone who expressed any of the following symptoms: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose

Select this box if you agree with the above statement

I have not travelled outside Nova Scotia during the past 14 days

Select this box if you agree with the above statement

Fifth Minor's Information


I, the undersigned, attest to the following: (please  tick the box beside each applicable attestation). In the case of a minor, "I" refers to that minor.

To the best of my knowledge, I do not have the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19, nor have I had it within the past 14 days

Select this box if you agree with the above statement

To the best of my knowledge, I have not been exposed to someone who has the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19 within the past 14 days

Select this box if you agree with the above statement

Within the past 14 days, I have not experienced any of the following that are new and not related to allergies or pre-existing conditions: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose

Select this box if you agree with the above statement

To the best of my knowledge, within the past 14 days, I have not been exposed to someone who expressed any of the following symptoms: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose

Select this box if you agree with the above statement

I have not travelled outside Nova Scotia during the past 14 days

Select this box if you agree with the above statement

Sixth Minor's Information


I, the undersigned, attest to the following: (please  tick the box beside each applicable attestation). In the case of a minor, "I" refers to that minor.

To the best of my knowledge, I do not have the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19, nor have I had it within the past 14 days

Select this box if you agree with the above statement

To the best of my knowledge, I have not been exposed to someone who has the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19 within the past 14 days

Select this box if you agree with the above statement

Within the past 14 days, I have not experienced any of the following that are new and not related to allergies or pre-existing conditions: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose

Select this box if you agree with the above statement

To the best of my knowledge, within the past 14 days, I have not been exposed to someone who expressed any of the following symptoms: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose

Select this box if you agree with the above statement

I have not travelled outside Nova Scotia during the past 14 days

Select this box if you agree with the above statement


Personal Delcaration

I, the undersigned, attest to the following: (please initial beside each applicable attestation). 


To the best of my knowledge, I do not have the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19, nor have I had it within the past 14 days 

Select this box if you agree with the above statement


To the best of my knowledge, I have not been exposed to someone who has the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19 within the past 14 days 

Select this box if you agree with the above statement


Within the past 14 days, I have not experienced any of the following that are new and not related to allergies or pre-existing conditions: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose

Select this box if you agree with the above statement


To the best of my knowledge, within the past 14 days, I have not been exposed to someone who expressed any of the following symptoms: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose

Select this box if you agree with the above statement


I have not travelled outside Nova Scotia during the past 14 days

Select this box if you agree with the above statement


By signing below, I confirm my understanding that I and/or my child may be refused participation in, or be asked to leave, this trip/rental, with no option for refund of payment, if any of the above attestations are found to be incorrect or if the status of those attestations changes between the time of signing of this form and any time before the end of the trip/rental.

Please enter your legal name as it appears on your passport.


Click to Sign
Signature


By checking here, you acknowledge you have read and understand the above terms, and are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.