Member Safety Agreement - Virginia Country Club

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COVID-19 MEMBER SAFETY AGREEMENT
TIMESTAMP REQUIRED. If the field is empty, please click on "Now."
Date/Time Stamp:*

Now

First Name:*

Last Name:*

Member Number:

E-mail:

If you agree to each of the checkmarked boxes below, please click on the submit button at the bottom.

Neither I, or anyone I have knowingly been exposed to, have been diagnosed with, or is suspected of having the COVID-19 virus.

I do not have symptoms such as a fever, cough, chest congestion, sinus congestion, or shortness of breath.

No one in my household currently has symptoms including fever, cough, chest congestion, sinus congestion, or shortness of breath.

Golf car use is limited to one per person – no exceptions.

I will practice safe hygiene and social distancing and maintain six (6) feet of space between myself and others.

I will wear personal protective equipment (PPE) whenever possible, including a face mask and gloves. The VCC staff will be wearing PPE at all times.

Statement of Agreement:*