COVID-19 Policy Acknowledgment

PhillyCAM remains committed to providing a safe and welcoming environment. COVID-19 new normal requires we institute new procedures including requiring all members and visitors to sign our COVID-19 Policy Member/Visitor Acknowledgment before being allowed entry to the PhillyCAM facility.

First Name *

Last Name *

Email *

Phone *

Symptoms Include: Fever of 100.4 degrees Fahrenheit or higher Dry Cough Shortness of Breath Chills Loss of taste or smell Sore Throat Muscle aches Any other symptoms that are added by the CDC, state, or local health departments or organizations with similar authority.

While we understand that many of these symptoms can also be related to non-COVID-19 related issues, we must proceed with an abundance of caution during the Public Health Emergency.

I understand that to enter upon the PhillyCAM facility I must be free from COVID-19 symptoms. If during the day, any of the following symptoms appear, I must immediately notify PhillyCAM’s Executive Director. *

Yes
No

I understand that I must always wear a CDC compliant face mask while at PhillyCAM and maintain a physical distance of 6 feet. *

Yes
No

I understand that PhillyCAM has adopted enhanced cleaning procedures and I will comply with all cleaning and disinfecting any equipment or work area I used as requested by staff. *

Yes
No

I will immediately notify PhillyCAM Executive Director if I become aware of any person with whom I have had contact exhibits any of the symptoms listed in Number 1 above, is advised to self-isolate, quarantine,or has tested positive, or is presumed positive for COVID-19. *

Yes
No

I understand that while at PhillyCAM I will be in contact with staff and other members of the public who are also at risk of community exposure. *

Yes
No

I understand that no list of restrictions, guidelines, or practices will remove 100% of the risk of exposure to COVID-19 as the virus can be transmitted by persons who are asymptomatic and before some people show signs of infection. *

Yes
No

I understand that I play a crucial role in keeping everyone at PhillyCAM safe and reducing the risk of exposure by following the practices outlined herein. *

Yes
No

By clicking 'Submit', I certify that I have read, understand, and agree to comply with the provisions listed herein. I acknowledge that failure to act in accordance with the provisions listed herein, or with any other policy or procedure outlined by PhillyCAM in response to COVID-19 will result in disciplinary action pursuant to policy established in PhillyCAM member handbook.

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COVID-19 Policy Acknowledgment