COVID-19 ATTESTATION

As part of our facility reopening plan and for the health and safety of our members and staff, all those entering the building are required to complete this attestation upon entry. 

I hereby attest that on this day the following are TRUE:

  • No one in my household including myself has experienced any of the following symptoms in the past 14 days: sore throat, cough, chills, body aches, shortness of breath for unknown reasons, loss of smell, loss of taste, fever at or greater than 100 degrees Fahrenheit

  • I do not have any reason to believe myself or anyone in my household has been exposed to or acquired COVID-19 in the past 14 days.

  • To the best of my knowledge I have not been in close proximity to any individual who tested positive for COVID-19 in the past 14 days.

  • I have not traveled within a State with significant community spread of COVID-19 for longer than 24 hours within the past 14 days.
    As of October 6 those States include:

    Alabama  Alaska  Arkansas  Colorado  Delaware  Florida  Georgia  Guam  Idaho  Illinois  Indiana  Iowa  Kansas  Kentucky  Louisiana  Minnesota  Missouri  Mississippi  Montana  North Carolina  North Dakota  Nebraska  Nevada  New Mexico  Oklahoma  Puerto Rico  Rhode Island  South Carolina  South Dakota  Tennessee  Texas  Utah  Wisconsin  West Virginia  Wyoming

I understand that if the above statements are not true of myself or anyone in my household, I will not be permitted to enter the facility on this day. The record of your attestation will be kept on file at the Fulton County YMCA in an effort to help with contact tracing.

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FULTON COUNTY YMCA

213 Harrison St.  Johnstown, NY 12095

Phone (518) 848-3447

Fax (518) 848-3463

Fulton County YMCA Residency

19 East Fulton St.  Gloversville, NY 12078

(518) 725-0627

OUR MISSION

To put Christian principles into practice

through programsthat build

healthy spirit, mind and body for all.

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