Form Builder

full bike rack

Required fields are marked with asterisks (*)

COVID-19 Screening Form

Completion of this COVID-19 screening form is mandatory for admittance to the City of Peterborough arena.

You are permitted to answer this COVID-19 screening survey on behalf of yourself and members of your immediate family/household who are entering the City of Peterborough arena with you today. Your answers will be used to generate a pass / fail response and may be shared with Public Health for contact tracing purposes only. If you receive a fail response, you will not be able to enter the facility and we suggest you contact Peterborough Public Health.

By answering these questions honestly, you are helping to minimize the spread of COVID-19.

Personal information is collected under the authority of Municipal Act, 2001, S.O. 2001, c. 25. The information will be used to screen for COVID-19 risk factors prior to entering the City of Peterborough arena.In the event of a confirmed COVID-19 diagnosis that coincides with your visit, by completing and submitting this form, you consent to the City sharing your name and contact information on file with Peterborough Public Health for purposes of contact tracing to reduce spread of COVID-19.

Effective 12:01 a.m. on October 18, 2021, individuals entering a City of Peterborough arena are required to confirm proof of vaccination or proof of a medical exemption, and provide personal identification, including all volunteers, coaches and officials, 12 years of age and older, in addition to the individuals prescribed by the Provincial regulation.  
In addition to the above, effective 12:01 a.m. on November 26, 2021, all persons 12 years of age and older actively participating in organized sports in a City of Peterborough arena are required upon entry to the facility, to confirm proof of vaccination or proof of a medical exemption, and provide personal identification.