Junior Program

Receipt of Review of Concussion Awareness Resource

Thank you for completing your review of the Concussion Awareness Resource.
• Under Rowan’s Law, your sport organization will ask you to confirm that you reviewed one of the Concussion Awareness Resources in this website (Ontario.ca/concussions) before you can register/participate in a sport.

• You must review one of the resources once a year, and then confirm that you have completed the review every time you register with a sport organization. If you want to use this form to show that you have reviewed the concussion awareness resource, you can provide the completed form to your sport organization(s).

• If you would like to have a record of your review of the concussion awareness resource, you can complete this form and keep it as a receipt to remind you of the date on which you reviewed it.

• Once you complete this form, you can save it (to your personal device/computer) or print this page to share with your sport organization and/or to serve as a reminder of when to review the Concussion Awareness Resources again next year

CURLING CANADA – INFORMED CONSENT AND ASSUMPTION OF RISK AGREEMENT
For Participants Under the Age of Majority
WARNING! Parent or Guardian, please read carefully.
By signing this document, you will assume certain risks and responsibilities.
Participant’s Name:
Participant’s Date of Birth (yyyy/mm/dd):
1. Thisis a binding legal agreement. Clarify any questions or concerns before signing.
2. As a Participant in the sport of curling and the activities, programs, classes, services provided and events sponsored or organized:
CURLING CANADA
[Insert Provincial Association]
[Insert Club]
(collectively the “Organization”), including but not limited to: games, tournaments, practices, training, personal training, dry land training,
use of strength training and fitness conditioning equipment, machines and facilities, nutritional and dietary programs, orientational or
instructional sessions or lessons, aerobic and anaerobic conditioning programs (collectively the “Activities”), the undersigned being the
Participant and Participant’s Parent/Guardian (collectively the “Parties”) acknowledges and agrees to the following terms outlined in this
agreement:
3. I am the Parent/Guardian of the Participant and have full legal responsibility for the decisions of the Participant.
Description and Acknowledgement of Risks
4. The Parties understand and acknowledge that:
a) The Activities have foreseeable and unforeseeable inherent risks, hazards and dangers that no amount of care, caution or expertise can
eliminate, including without limitation, the potential for serious bodily injury, permanent disability, paralysis and loss of life. The sport
of curling is played on a sheet of ice, which is slippery, hard, and dangerous;
b) A pertinent risk to participating in the sport of curling is the risk of suffering serious head injury should the Participant fall, trip, or
stumble onto the ground or ice. It is highly recommended that the Participant wear a helmet at all times when participating in the sport
of curling;
c) The Organization has a difficult task to ensure safety and it is not infallible. The Organization may be unaware of the Participant’sfitness
or abilities, may misjudge weather or environmental conditions, may give incomplete warnings or instructions, and the equipment
being used might malfunction;
a) The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization and COVID-19 is
extremely contagious. The Organization has put in place preventative measures to reduce the spread of COVID-19; however, the
Organization cannot guarantee that the Participant will not become infected with COVID-19. Further, participating in the Activities could
increase the Participant’s risk of contracting COVID-19.
5. The Participant is participating voluntarily in the Activities. In consideration of that participation, the Parties hereby acknowledge that they
are aware of the risks, dangers and hazards and may be exposed to such risks, dangers and hazards. The risks, dangers and hazards include,
but are not limited to:
a) Health: executing strenuous and demanding physical techniques, physical exertion, overexertion, stretching, dehydration, fatigue,
cardiovascular workouts, rapid movements and stops, lack of fitness or conditioning, traumatic injury, bacterial infections, rashes,
and the transmission of communicable diseases, including viruses of all kinds, COVID-19, bacteria, parasites or other organisms or
any mutation thereof.
b) Premises: defective, dangerous or unsafe condition of the facilities; falls; collisions with objects, walls, equipment or persons;
dangerous, unsafe, or irregular conditions on floors, ice, or other surfaces, extreme weather conditions; travel to and frompremises.
APPENDIX #4
Informed Consent & Assumption of Risk Agreement 2
c) Use of Equipment: mechanical failure of the equipment; negligent design or manufacture of the equipment; the provision of or the
failure by the Organization to provide any warnings, directions, instructions or guidance as to the use of the equipment; failure to
use or operate the equipment within my own ability.
d) Contact: contact with brooms, brushes or curling stones, other equipment, vehicles, or other persons, and may lead to serious
bodily injury, including but not limited to concussions and/or other brain injury, or serious spinalinjury.
e) Advice: negligent advice regarding the Activities.
f) Ability: Failing to act safely or within my own ability or within designated areas.
g) Sport: the game of curling and its inherent risks, including but not limited to, running, sliding or slipping on the ice surface, delivering
the curling stone, skipping or sweeping, stepping onto the ice surface from the walkway or onto the walkway from the ice surface,
or stepping over dividers that divide one sheet of ice from the next.
h) Cyber: privacy breaches, hacking, technology malfunction or damage.
i) Conduct: My conduct and conduct of other persons including any physical altercation between participants.
j) Travel: Travel to and from the Activities.

Background: The Lancaster and District Curling Club is committed to the safety of all members and non-members who curl at our Club.

Our Helmet Policy follows the helmet use recommendations of Curling Canada.
For Curlers Aged 12 and under.
1. Helmets are mandatory for all curlers aged 12 and under.
2. Helmets must be CSA – approved, and can be a skating, hockey, snowboarding, or skiing helmet.
3. The helmet is to be secured on the curler’s head prior to entering the ice, remain on for the duration of play, and not be removed until they have exited the arena.
4. It is the parent(s) or guardian(s) responsibility to ensure the helmet is secured properly.
For Curlers between the ages 13 and 17,
5. For Curlers over the age of 12 and under 18, it is highly recommended that a helmet be worn.