Imagine Swimming COVID-19 Symptom Survey & Attestation Form

Parent, Guardian, or Lap Swimmer Name *

First Name Last Name

Parent/Guardian/Lap Swimmer's Email *

example@example.com

Parent/Guardian/Lap Swimmer's Phone *

Please enter a valid phone number.

First Participant's Name (lap swimmers, enter your name here) *

First Name Last Name

Second Participant's Name

First Name Last Name

Third Participant's Name

First Name Last Name

I attest that each of the following are true to the best of my knowledge (CHECK ALL THAT APPLY - LEAVING ANY BLANK WILL INDICATE POSSIBLE EXPOSURE TO COVID-19):

Neither myself nor the participant(s) are experiencing any new or unusual symptoms of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell. Neither myself nor the participant(s) have traveled internationally within the last 14 days. Neither myself nor the participant(s) have traveled to a highly impacted area within the United States of America in the last 14 days. I do not believe that either myself or the participant(s) have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19. Neither myself nor the participant(s) have been diagnosed with Coronavirus/COVID-19, without yet having been cleared as non-contagious by state or local public health authorities. I myself, and the participant(s), are following all CDC recommended guidelines as much as possible and are limiting our exposure to the Coronavirus/COVID-19.

Imagine Swimming Flagships COVID-19 Policies & Procedures Statement

All guests will have their temperature taken upon entry and will be asked to attest that, to the best of their knowledge, they have not been exposed to COVID-19.
Proper cloth masks that cover the mouth and nose completely, social distancing, and frequent hand washing or sanitizing will be required when in the facility. For safety, masks should not be worn inside the pool, but must be worn everywhere else.
Guests must adhere to all COVID-19 protocols, signage, and the direction of staff at all times.
Guests must remain at least 6’ apart while swimming, except from members of their immediate family.
Swimmers should arrive no more than 5 minutes prior to their planned start time, with their suits on underneath their street clothes to minimize the amount of time spent in changing areas, and leave within 5 minutes of finishing their swim.
Class durations have been shortened by 5 minutes to allow additional transition time between lessons, reducing crowding in the facilities.
Private shower stalls will remain closed to minimize the amount of time spent in the facility after swimming, and to facilitate our staff’s constant cleaning & disinfecting efforts.
Open and on-deck showers will be available to quickly rinse before and after swimming. In order to prevent water quality issues, no soap, bodywash, shampoo, or conditioner can be used in the on-deck showers at our Tribeca Flagship.

I have read and understood the Imagine Swimming Flagships COVID-19 Policies & Procedures Statement and agree to comply with all policies & procedures therein, and to any additional guidance from Imagine Swimming staff. *

I agree. I DO NOT agree.

Parent or Guardian Signature *

Clear

Date

Hour Minutes AM/PM Option