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Thank you for choosing to use the facilities, services or programs offered through the Cowichan Valley Regional District, the Municipality of North Cowichan and the Town of Ladysmith.
Personal Information is collected by the Municipality of North Cowichan, the Cowichan Valley Regional District, and the Town of Ladysmith (“the Local Governments”) under the authority of section 26(c) of the Freedom of Information and Protection of Privacy Act for the purpose of administering recreation programs and recreation facilities. Should you have any questions about the collection of this personal information please contact:
Deputy Director of Corporate Services, Municipality of North Cowichan
250-746-3100; Box 278, 7030 Trans Canada Hwy, Duncan, BC V9L 3X4
We request your understanding and cooperation in maintaining both your/your child’s and our safety and health by reading and signing the following INFORMED CONSENT.
I declare that I intend to use some or all of the activities, facilities, programs and services offered through the Local Governments,and I understand that each person, (myself/my child included), has a different capacity for participating in such activities, facilities, programs and services.I am aware that all activities, services and programs offered are either educational, recreational, or self-directed in nature.I assume full responsibility during and after my/my child’s participation, for my choices to use or apply, at my own risk, any portion of the information or instruction I receive.
I understand that part of the risk involved in undertaking any activity or program is relative to my own/ my child’s state of fitness or health (physical, mental or emotional) and the awareness, care and skill with which I/my child conduct my/him/herself in that activity or program.I acknowledge that my/my child’s choice to participate in any activity, service and program brings with it the assumption by me of those risks or results stemming from this/these choice(s) and the fitness, health, awareness, care and skill that I/my child possess and use.In addition, I understand that I am free to withdraw from, reduce or modify my/my child’s involvement in any program activity and I realize that I should do so upon recognition of any signs of transient lightheadedness, fainting, chest discomfort, leg cramps, nausea, etc.
I further understand that the activities, programs and services offered by the Local Governments are sometimes conducted by personnel who may not be licensed, certified, or registered instructors or professionals.I accept the fact that the skills and competencies of some employees and/or volunteers will vary according to their training and experience and that no claim is made to offer assessment or treatment of any mental or physical disease or condition by those who are not duly licensed, certified or registered and herein employed to provide such professional services.
In addition, I acknowledge that I have inquired about the nature of any activity, program or services that I am not completely familiar with and I have been informed of any inherent risks.
I declare that I have read, understood and agree to the contents of this INFORMED CONSENT AGREEMENT in its entirety.