I, the undersigned, agree to provide evidence of my vaccination status to CTEH and Lionsgate (Company). I understand that I will be required to present my vaccination card as requested by the Company and CTEH, and my vaccination card may be copied for retention by the Company and CTEH. I certify that, to the best of my knowledge, the vaccination card that I have attached here is valid and current, and was created and presented to me in conjunction with my receipt of the COVID-19 vaccine. I consent to the Company and CTEH’s review of this vaccination record so that the Company and CTEH may independently validate my vaccination status.
I understand that the Company and CTEH will take steps to protect my identity and the confidentiality of my information. I also understand that the Company and CTEH may disclose my personal information to public health authorities and/or legal counsel where required by applicable law.
By clicking below, you authorize the Company and CTEH to document and validate your vaccination status, as needed. You are entitled to a copy of this consent form. Any questions regarding this consent form should be directed to your employer or designated Health and Safety representative.