Please complete this form in its entirety. Bring the email confirmation with you to present to staff.
- Fever or chills- Cough or barking cough (croup)- Difficulty breathing or shortness of breath- Decrease or loss of smell or taste- Nausea, vomiting, diarrhea if less than 18 years old- Extreme tiredness or muscle aches if more than 18 years old2. Have you or anyone in your household had any of the following?- In the last 14 days travelled outside of Canada AND been advised to quarantine per the federal quarantine requirements- had a doctor, health care provider, or public health unit tell you that you should currently be isolating (staying at home)- In the last 10 days been identified as a "close contact" of someone who currently has COVID-19- In the last 10 days received a COVID Alert exposure notification on your cell phone- In the last 10 days tested positive on a rapid antigen test or home-based self-testing kit
I hereby release and save harmless The Corporation of the Town of Gravenhurst and its employees and representatives from any and all claims and demands associated with my acquiring COVID-19, from working at or visiting a Town of Gravenhurst site, due to any cause whatsoever, including negligence, breach of contract, mistakes or errors in judgment. This Release of Liability shall be binding upon my heirs, next of kin, executors, administrators, assigns and representatives.
Contact Us
It appears you are trying to access this site using an outdated browser. As a result, parts of the site may not function properly for you. We recommend updating your browser to its most recent version at your earliest convenience.