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I have fully read and understand The Aylmer-Malahide Museum & Archives Vaccination Policy and attest, that as of today, I am fully vaccinated under the current Health Canada guidelines and will upload my COVID-19 Vaccination Receipt from the Ontario Health website.
Yes.No, in progress to obtain full vaccination.No.
If yes, upload your proof of vaccination here. Only proof of your second vaccination is required if fully vaccinated.
If no, upload your proof of exemption here.
Notice of Collection
Information collected will be managed in accordance with the Personal Health Information Protection Act. The collected information will be maintained and used for the following purposes:
- to take reasonable precautions for the health and safety of Aylmer-Malahide Museum & Archives staff and visitors;
- to align with the provincial approach to COVID-19 immunization disclosure policies;
- to optimize COVID-19 vaccination rates;
- to ensure that individuals have access to information required to make informed decisions about COVID-19 vaccinations;
- to ensure that individuals not vaccinated for COVID-19 are being routinely tested; and
All collection, use and/or disclosure of this information is in accordance with the Municipal Freedom of Information and Protection of Privacy Act R.S.O 1990 c.M.56.
If you have any questions or concerns about the collection of information, please contact The Aylmer-Malahide Museum & Archives, 14 East St., Aylmer, Ontario N5H 1W2, Tel: (519) 773-9723, or email email@example.com