Ellerslie Campus Occupant Agreement

First Name *

Last Name *

Participant's Email *

Today's date * +

The Ellerslie event you are attending *

In order to honor those with health and safety concerns, Ellerslie has adopted some specific health and safety protocols for those attending our 2021 programs. Please take a moment to read and fill out this form in its entirety. We appreciate your cooperation!

I understand that if I have been diagnosed with COVID-19 within 7 days prior to my arrival at Ellerslie, I will not be permitted to attend sessions or stay as a guest on the Ellerslie Campus until I am no longer contagious. (If this is the case please contact us at info@ellerslie.com to discuss options.) * If I have been knowingly exposed to COVID-19 within 7 days of my arrival, I agree to notify the Ellerslie staff prior to my arrival so we can work together to make the best decision about my arrival and participation. *

I understand

I understand that if I am experiencing any symptoms of cold, flu, or potentially contagious illness, I should contact Ellerslie at info@ellerslie.com to discuss my situation. *

I understand

I understand that I may be sharing a room with 1, 2, or 3 other students/guests, and/or sharing a bathroom with 3 to 6 other students/guests. I understand that if my suite-mates begin to exhibit symptoms they may be relocated or isolated. I understand that if I begin to display symptoms during my stay, I am required to alert campus staff immediately, and I will be required to self-isolate. *

I understand

I understand that if I am uncomfortable sharing a room with other guests or a bathroom with other guests, I could choose the Off-Campus option. *

I understand

I understand that strict sanitation guidelines must be followed for guest rooms and bathrooms, including frequent sanitation of high-touch surfaces and specific cleaning guidelines after use of the shared bathroom. These guidelines will be posted in each guest room and bathroom, and I agree to read and follow them during my entire stay. *

I understand

I understand that cleaning materials will be supplied in each guest room and bathroom and that I am required to use these, unless I obtain an exception from a campus staff member to use my own cleaning materials. *

I understand

I understand that the shared kitchens in the dorm common areas may not be available for use during my stay, in which case, all personal food must be kept in sealed containers in my own guest room. (Note - if you are a student with special dietary needs that require refrigeration, please communicate with our Ellerslie staff and we will seek to accommodate your needs.) *

I understand

I understand that I am choosing to stay as a guest on the Ellerslie Campus at my own risk and I will not hold the ministry of Ellerslie liable for any health issue that may arise as a result of my stay. *

I understand

I understand that if I am uncomfortable with any of these requirements or guidelines, I should not not plan to attend Ellerslie at this time. *

I understand

Any Comments? (not required)

Participant's signature *

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Parent's or legal guardian's signature (if participant is under 18 years of age)

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