LGYC ATTESTATION FORM

  • Lake Geneva Yacht Club

    COVID-19 SELF-SCREEN/MONITOR ATTESTATION

  • The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact.  Lake Geneva Yacht Club (“LGYC”) has put in place preventative measures to reduce the spread of COVID-19; however, LGYC cannot guarantee that you, or your child/family, will not become infected with COVID-19.  An individual’s risk of contracting COVID-19 could be increased by participation in LGYC sponsored sailing and social events, and activities ancillary thereto including, but not limited to, use of LGYC’s property, clubhouse, and facilities, motor boating, sail boating, swimming, running, exercising, playing social and competitive games, and participating in LGYC sponsored regattas and races (collectively, the “LGYC Activities”).

    By signing this agreement, I, acknowledge the contagious nature of COVID-19  and voluntarily  assume  the risk that I may be exposed to or infected by COVID-19 by participation in LGYC Activities; and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the LGYC Activities may result from the actions, omissions, or negligence of myself and others, including, but not limited to, LGYC’s employees, officers, directors, agents, volunteers, members, representatives and program participants and their families.  Further, I understand and acknowledge that by the nature of the LGYC activities, including sailing on certain types of boats, the Participant may not be able to or capable of social distancing or taking other preventative measures to reduce the risk of COVID-19 during participation in LGYC activities. I attest to the following: 
    1. I will conduct DAILY self-monitoring and evaluation(s) of our household members and each sailor entering LGYC premises and/or involved in LGYC programs or activities.
    2. I will abide by all Federal, State, County, White House, CDC and LGYC Lakefront and premises usage guidelines relating to COVID-19 while on LGYC premises or participating in LGYC activities.
    3. I agree to practice safe social distancing and clean hygiene during any participation in LGYC activities.
    4. I do not have any of the following symptoms that the CDC recognizes as being associated with COVID-19: fever, cough, shortness of breath or difficulty breathing, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell. 
    5. If I have tested positive I confirm that a repeat negative test has cleared me for full activity
    6. To my knowledge, in the last 14 days, I have not been exposed to other person(s) that have either recently tested positive for COVID-19 and that have not been cleared by a medical provider or have the symptoms associated with COVID-19 listed in Item 4, above;
    7. If I have been requested by any government entity or any medical provider to quarantine or self-isolate to prevent against possibly exposing others to COVID-19; I have fulfilled my quarantine or advised medical treatment and have been cleared of active disease.
    8. I will promptly notify the LGYC office by phone (262-275-2727) and email (clubmanager@lgyc.com and exesecy@lgyc.com) if any of my answers to Items #1-6 change after the date of this attestation.