COVID19 Guest Declaration Form

COVID-19 GUEST DECLARATION INFORMATION FORM

Name*

Name of Member Playing with*

Email Address*

Phone Number

Date Playing*

Additional Name

I hereby declare that I or anyone in my household has not experienced any cold or flu-like symptoms in the last 14 days (to include fever, cough, sore throat, respiratory illness, difficulty breathing). If I or anyone in my household experience any cold or flu-like symptoms after submitting this declaration, I will then not visit the club for a minimum period of 14 days after the cold or flu-like symptoms have completely gone away. This agreement will remain in effect until the Board of Directors of Beverly Golf Club declare the requirements in this declaration are no longer in effect. *
I Agree

I hereby declare that I or any member of my household have not traveled to or had a lay-over in any country outside Canada in the past 14 days. If I or anyone in my household travel to any country outside Canada after submitting this declaration, I will then not visit Beverly Golf Club for a minimum period of 14 days after the date of return to Canada. This agreement will remain in effect until the Board of Directors of Beverly Golf Club declare the requirements in this declaration are no longer in effect. *

I Agree

I have read and understand the above “BEVERLY GOLF CLUB DECLARATION" as communicated by the club and accept and waive any right to golfing privileges should I not comply with these policies. *
I Agree

Date*