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EDLAVITCH DC JEWISH COMMUNITY CENTER COMMUNITY HEALTH + SAFETY AGREEMENT

We pledge to you:

  • First and foremost, always prioritize the health and safety of our community.
  • Follow all health and safety guidelines as outlined by the Centers for Disease Control and the Government of the District of Columbia.
  • Promote social distancing, adhere to the maximum capacity guidelines, require all staff to wear PPE including face masks while in public spaces, and employ new policies - such as no eating or gathering in public spaces - until it once again is safe to do so.
  • Increase the frequency of cleanings that take place throughout the day, especially in high-traffic areas. Additionally, the EDCJCC will close once a month for a deep cleaning of the entire facility, and increased circulation of fresh air will be maintained throughout the building using our new HVAC and Direct Outdoor Air Supply Unit.
  • Continue to educate all staff on policies and guidelines so they can provide the safest and most enjoyable experience for all visitors.

We ask you to pledge to:

  • Refrain from entering the Center if in the past fourteen days, you or someone you’ve been in close contact with has had a body temperature of 100.4+ degrees or have experienced any of the symptoms itemized below:
    • Fever orchills
    • Cough
    • Shortness of breath or difficulty breathing
    • Fatigue, muscle, or bodyaches
    • Headache
    • New loss of taste or smell
    • Sorethroat
    • Congestion or runnynose
    • Nausea, vomiting, ordiarrhea
  • Agree to have your body temperature taken with a non-contact forehead thermometer immediately upon entering the Center.
  • Practice social distancing by maintaining at least six feet of distance between others and myself.
  • Wear a protective facemask that covers my nose and mouth when entering and walking around the Center. This requirement does not apply to children under two or to individuals who are unable to wear a face covering due to a medical condition. Fitness Center members may lower or remove their face mask if it inhibits breathing during aerobic activity.
  • Wash your hands with soap and warm water for at least 20 seconds upon entering the Center and prior to exiting the Center.
  • Avoid using any furniture, spaces, equipment, entrances/exits, or other areas, such as locker rooms and specific restrooms, that have been designated as closed-off.
  • Be mindful that these regulations are subject to change based on changing requirements and recommendations provided by public health resources.
  • Adhere to the new rules and regulations specific to individual spaces such as the Fitness Center and Early Childhood, Youth, and Family Wing. These regulations will be provided to users of these spaces in a separate correspondence.
  • Until the building opens to the community at large, only arrive to use the Center during scheduled appointment times, and adhere to all check in and check out procedures.

By signing this agreement and waiver of liability, I acknowledge and agree that:

  • The Edlavitch DCJCC (EDCJCC) has put in place rules, policies, guidelines, signage, and instructions (collectively, Preventive Measures) to reduce the risk of spreading the Coronavirus/COVID-19;
  • I will comply with all EDCJCC Preventive Measures;
  • The health and safety of the community is of the utmost important to the EDCJCC, as reflected in the Preventive Measures put in place;
  • I am personally responsible for my safety and the actions of those of my family and anyone under my care when using the EDCJCC’s facilities;
  • For myself and my family and those under my care, I assume the foregoing risks and release the EDCJCC, its board members, officers, agents, employees and successors of the foregoing (collectively, the “EDCJCC Organization”) from all liability, claims, demands, and causes of action arising from any loss, damage, injury or death that may be sustained by me related to COVID-19, other than if by gross negligence of the EDCJCC Organization, while participating in any EDCJCC activity or using the EDCJCC’s facilities or materials;
  • I have read and understand the foregoing waiver of liability and sign it voluntarily;
  • I am at least eighteen (18) years of age; and
  • This agreement and waiver of liability is governed by District of Columbia law.

Date: June 15, 2021 

 

First Visitors Name

First Name*

Last Name*
First Visitors Date of Birth*
I certify that I am 18 years of age or older
First Visitors Signature*
Second Visitors Name

First Name*

Last Name*
Second Visitors Date of Birth*
Third Visitors Name

First Name*

Last Name*
Third Visitors Date of Birth*
Fourth Visitors Name

First Name*

Last Name*
Fourth Visitors Date of Birth*
Fifth Visitors Name

First Name*

Last Name*
Fifth Visitors Date of Birth*
Sixth Visitors Name

First Name*

Last Name*
Sixth Visitors Date of Birth*
Seventh Visitors Name

First Name*

Last Name*
Seventh Visitors Date of Birth*
Eighth Visitors Name

First Name*

Last Name*
Eighth Visitors Date of Birth*
Ninth Visitors Name

First Name*

Last Name*
Ninth Visitors Date of Birth*
Tenth Visitors Name

First Name*

Last Name*
Tenth Visitors Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and program updates by e-mail.
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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