585.223.7874
Memberships
Midvale
Membership Specials
Paid in Full Memberships
Membership Policies
Summer College Pass
Personal Training
MEMBER LOG IN
More
Use tab to navigate through the menu items.
Covid-19 Vaccination Declaration
First Name
Last Name
Select an option
Fully Vaccinated : Received at least 2 doses of COVID-19 Vaccine, with last dose at least 14 days ago.
Masks Required: Not fully vaccinated, would rather not provide vaccination status
Optional, Please upload your vaccination record here.
Upload File
Upload supported file (Max 15MB)
Initials
Date
I declare that the info I’ve provided is accurate & complete. *Form only needs to be filled out once.
Submit
