All prices are in Canadian dollars (CAD)

COVID-19 Information and Liability Waiver

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. New Path Spa by Magda Sosin. Has put in place guide lines, preventative measures to reduce the spread of COVID-19. However, New Path Spa by Magda Sosin. cannot guarantee that you will not become infected with COVID-19. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk I may be exposed to or infected by COVID-19 by attending the Spa and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by New Path Spa by Magda Sosin. May result from the actions, omissions, or negligence of myself and others, including, but not limited to, employees, customers . I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my attendance at the Spa. On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the Spa, its employees of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any claims based on the actions, omissions, or negligence of the Spa, its employees and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Spa service.

Name*
MM slash DD slash YYYY
Do you have new or worsening symptoms?
Fever and/or chills*
Cough and/or barking cough*
Shortness of breath*
Decrease or loss of taste and/or smell*
Sore throat or trouble swallowing*
Runny or stuffy nose*
Abdominal pain that is persistent or ongoing (not related to known causes or conditions e.g., menstrual cramps, gastroesophageal reflux disease)*
Headache that is unusual or long lasting*
Conjunctivitis (pink eye)*
A decreased or lack of appetite*
For adults (18 years of age or older): Tiredness, muscle aches or joint pain*
For children (under 18 years of age): Nausea, vomiting and/or diarrhea*
In the last 14 days, have you or someone you live with travelled outside of Canada AND been advised to quarantine (as per federal quarantine requirements)?*
Has a doctor, healthcare provider, or public health unit told you that you should currently be isolating (staying at home)?*
In the last 10 days, have you been identified as a “close contact” of someone who currently has COVID-19?*
In the last 10 days, have you tested positive on a rapid antigen test or a home-based self-testing kit?*
In the last 10 days, have you received a COVID Alert exposure notification on your cell phone?*
In the last 10 days, has someone you live with been identified as a “close contact” of someone who currently has COVID-19 AND advised by a doctor, healthcare provider or public health unit to self-isolate?*
Is anyone you live with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms?*
If “yes” to any of the above, do not enter. Go home, self-isolate and seek testing.
This field is for validation purposes and should be left unchanged.

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© New Path Spa by Magda Sosin | 729 Gardiners Rd, Kingston, ON K7M 3Y5
Phone: (613) 634-9611 | Email: [email protected] | All prices are in CAD.
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