Red Rose Convention Centre will require all attendees to be screened upon arrival. Each attendee must fill out a COVID-19 questionnaire that also contains their contact information to ensure we are meeting government regulations. Any attendees unwilling to do so will be denied entry (this includes names, contact information and date of visit). This will help support case and contact tracing in the event of an outbreak. This completed form must be shown to the personnel representing Red Rose Convention Centre prior to entering.

Please note, you are only allowed to enter other family members if the live in the same household and have the same physical address. Otherwise, 2 separate forms will have to be submitted.


Date of Visit
Postal Code

COVID-19 Questionnaire:

1. Are you fully vaccinated ? Yes    No

Please answering the following:

2. Have you or any family members listed above travelled outside of Canada or been in contact with anyone who has travelled outside of Canada in the last 14 days? Yes    No

3. Do you or any of the family members listed above have any of the following Flu like symptoms?

Fever Yes    No   
Cough Yes    No   
Shortness of Breath Yes    No   

4. Have you or any family members listed above been in contact with someone diagnosed with COVID-19 in the last 14 days? Yes    No

If you have answered yes to any of the above please note due to the safety of all guests we cannot let you enter at this time but would love to have you come back for another occasion.

5. Do you and the above-mentioned family members agree to social distance yourself from others and maintain a distance of at least 2 metres from anyone on site? Yes    No

I declare that the answers provided to the questions on this online report are true to the best of my knowledge.

I understand this information will be used to determine my eligibility for entering the venue and is for contact tracing purposes.

I understand the information I have provided is subject to verification and that giving false information for myself or someone other than myself constitutes fraud.

Please note that by filling out this report, you will be deemed to have signed your online report.


1233 Derry Rd E,
Mississauga, ON
L5T 1B6



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