Village of Lewiston Recreation - Weight Room/Fitness Center - Friday, November 27, 2020
Village of Lewiston Recreation
Address: 145 N. 4th Street, Lewiston, NY 14092
Contact us at (716) 754-1990 or recreation@villageoflewiston.com

Per New York State, our fitness center is operating on a third of capacity basis. This means that we can have only four people in the fitness center at a time. This has required us to require our fitness center members to pre-register for time slots to workout. Please note that you are able to workout during that time frame only. If you miss your time slot, you will not be able to workout at a different time that day unless room is available. We need time to disinfect between groups of individuals utilizing our facility. Masks are required at all times in the facility.

Release of Liability:
In consideration of permitting the below-named child to participate in games, practices, and other activities of the Village of Lewiston Recreation Department, I, the undersigned as parent or guardian of said minor, do hereby release and agree to hold harmless the Village of Lewiston Recreation Department and its said agents, employees, coaches and volunteers from any liability for bodily injury, personal injury or property damage which may occur to said minor on the part of said program or its agents, employees, coaches and volunteers related to this program.

Village of Lewiston Recreation Department
COVID-19 Screening Questionnaire

The following is a current list of COVID-19 symptoms that have been identified by the Center for Disease Control and Prevention (CDC):

Fever or chills
Cough
Shortness of breath or difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore Throat
Congestion or runny nose
Nausea or vomiting
Diarrhea

If your answer is “YES” to any of the COVID questions below, please do not enter the Recreation Facility.
Have you experienced any COVID-19 related symptoms (Listed Above) in the past 48 hours?
Clear selection
Within the past 14 days, have you been in close physical contact (6 feet or closer for at least 15 minutes) with a person who is known to have laboratory-confirmed COVID-19 or with anyone who has any symptoms consistent with COVID-19?
Clear selection
Are you isolating or quarantining because you may have been exposed to a person with COVID-19 or are worried that you may be sick with COVID-19?
Clear selection
Are you currently waiting on the results of a COVID-19 test?
Clear selection
Last Name *
First Name *
Phone Number *
Select one time slot per day *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy