Name Mobile No. Email Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Address Attendance 12345678910+ What will you be bringing with you? Declaration I have not experienced or done any of the following: Fever, coughing, difficulty breathing, sore throat, runny nose, and shortness of breath. Neither I, nor anyone in my household, has travelled outside Ontario in the past 14 days. I have not been investigated, nor tested positive, nor have been in contact with anyone who has been tested positive for COVID-19 in the past 14 days. (Please take this self-assessment if you’re worried you were exposed to COVID-19 (novel coronavirus) or have symptoms https://covid-19.ontario.ca/self-assessment/) Release of Liability Yemeni Canadian Club has no control over the potential spread of the various and other ailments and you expressly agree to hold harmless Yemeni Canadian Club and it’s management, staff & volunteers in the event you contract any ailment found to be contracted as a result of your attendance to the event. Submit