Contact

 

 

 

 

 

 

 

 

 

Address:

Manitou Opera House
325 Main Street
Box 63
Manitou MB R0G 1G0
Canada

Phone:

For assistance with bookings, please call:

204-242-4414           Al Thorleifson – Concerts & Coffee House Musicians

204-825-8406          Richard J. Klassen – Candlewick Theatre Events

204 242 4490            Laura Greenfield – Caretaker

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Manitou Opera House COVID Waiver

COVID-19 Virus Health Disclosure for In-Person  Opera House Attendance

Please feel free to copy and past this document to submit with your booking request. 

This declaration is made in connection with my attendance in regularly scheduled classes, programs, or events at the Manitou Opera House, located in Manitou Manitoba.

 

I, _______________________________(print name), will be attending

_________________________________(name of EVENT/CLASS/PROGRAM)

on ______________________________, 20___ (date)

and (list if appropriate) on subsequent occasions as scheduled, in the following capacity:

_____________________________________________________________________

I confirm the following statements to be true (check all that apply):

  1. I have not been diagnosed with a lab-confirmed probable or positive case of the COVID19 virus. _______
  2. I have not travelled anywhere outside of CANADA OR PLACES THAT REQUIRE YOU TO SELF ISOLATE, nor have I been in contact with anyone who has travelled outside of Manitoba, in the last 14 days. _______
  3. I have not experienced any of the following symptoms in the last 14 days: fever, dry cough, shortness of breath, loss of sense of taste, loss of sense of smell, or difficulty breathing. _______
  4. I have not knowingly come into contact with anyone experiencing any of the following symptoms in the last 14 days: fever, dry cough, shortness of breath, loss of sense of taste, loss of sense of smell, or difficulty breathing. _______
  5. I have not knowingly come into contact with anyone in the last 14 days who has been diagnosed with a lab-confirmed probable or positive case of the COVID-19 virus. _______
  6. I am aware that I will not be admitted into the CLASS/PROGRAM site, or will be asked to leave the CLASS/PROGRAM site, if I answer in the affirmative to any statement listed above. _______

I acknowledge and agree that:

My participation in EVENTS/CLASSES/PROGRAMS at the Manitou Opera House is a privilege and I agree to follow all protocols requested by the Management Committee including the use of sanitizers and the regular cleaning of equipment and surfaces used during my participation in the CLASSES/PROGRAMS. I recognize that, if I refuse or neglect to adhere to these protocols, I will be refused access to the site without reimbursement of costs.

In the event that during my CLASS PARTICIPATION, I should experience any of the symptoms stated in 3 above(fever, dry cough, shortness of breath, loss of sense of taste, loss of sense of smell, or difficulty breathing), I will immediately identify this to the EVENT/CLASS/PROGRAM SUPERVISOR and will leave the site.

In the event that during the next 14 days, I should experience any of the symptoms stated in 3 above (fever, dry cough, shortness of breath, loss of sense of taste, loss of sense of smell, or difficulty breathing), or learn of any circumstances that would change my response to any of the above questions, I will immediately inform the CLASS/PROGRAM SUPERVISOR.

I am aware of the inherent health risks and concerns related to my attendance at the EVENT/CLASS/PROGRAM site, and with any contact I may have with those present at the EVENT/CLASS/PROGRAM site and I am attending the EVENT/CLASS/PROGRAM site of my own free will and accord. I will not hold the EVENT/CLASS/PROGRAM provider, the Manitou Opera House Foundation or Pembina Municipality or other persons attending the EVENT/CLASS/PROGRAM site responsible for any claims, costs, damages, expenses, or liability related to any adverse health-related consequences arising as a result of attending the EVENT/CLASS/PROGRAM or the Manitou Opera House site.

To the best of my knowledge, everything contained herein is true, and this declaration may be relied upon as having the same force and effect as if made under oath.

_____________________________      ___________________________

(Signature of Declarant ….. and Parent Signature, if declarant is under age eighteen)

_____________________________     _____________________________

(Name)                                                                                            (Mailing address)

_____________________________     ____________________________

(Phone number)                                                                                      (Email address)

Date: _______________________________________, 20___.

* This declaration must be completed and provided to the site administrator no later than on the day of the EVENT/CLASS/PROGRAM.  The individual identified in section 1 of this form will not be admitted to the CLASS/PROGRAM site unless this form is completed. The EVENT/CLASS/PROGRAM site administrator who receives this declaration will provide it to any other supervisor as is required by the site processes. This document may be submitted electronically with the completion of the area for the name of the declarant being deemed to be the declarant’s signature.

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Contacts:

If you would like to purchase tickets for an upcoming event, please go to the Booking Calendar and click on the event. A description of the event will open. You will find the ticket contact’s phone number there.

Richard J. Klassen: Management Chair / Lighting
Ph: 204-825-8406
Email: [email protected]

Al Thorleifson: Treasurer, Manitou Opera House Management Committee
Ph: 204-242-2794
Email: [email protected]

Dale Dobson: Foundation Chair
Ph: 204-242-2607
Email: [email protected]

Bill Howatt: Sound Technician
Ph: 204-242-2531
Email: [email protected]