Masters Daily Health Screening
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Athlete Name
Email Address
Location
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I have an active YMCA of the North Shore membership (if not, please contact your local YMCA to enroll or reactivate your membership)
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Have you or a family member traveled outside of Massachusetts, Rhode Island, Connecticut, Vermont, New Hampshire, Maine, New York, and New Jersey within the last 14 days?
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I agree that neither I nor any member of my household have a suspected or confirmed case of COVID-19 or are experiencing symptoms of COVID-19, including but not limited to fever, cough, or shortness of breath.
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 The Y is committed to a clean, safe, and healthy environment for our staff and members. This waiver is a requirement from our insurance company. We are following guidelines and are confident in our plans to keep staff and members safe. I fully understand both the known and potential dangers of utilizing the facilities, services, and programs of the YMCA and acknowledge that use thereof may, despite the YMCA’s reasonable efforts to mitigate such dangers, result in exposure to COVID-19. By typing my name below, I attest that I have read and agree to the Assumption of Risk, Release and Waiver of Liability agreement.
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