1. Fever
      YesNo

    2. Dry Cough
      YesNo

    3. Fatigue?
      YesNo

    4. Aches and Pains
      YesNo

    5. Runny Nose
      YesNo

    6. Sore Throat
      YesNo

    7. Shortness of Breath
      YesNo

    8. Diarrhea
      YesNo

    9. Headache
      YesNo

    10. Loss of Smell and Taste
      YesNo

    11. In consideration of being allowed to use the Club's sports facilities and amenities and undertake certain activities in the Club's facilities, I understand, acknowledge, and agree that:

      1. The safety and health protocols put in place by Management do not guarantee the total elimination of infectious diseases including but not limited to flu, influenza, and COVID-19

      2. The use of Club sports facilities and undertaking of certain activities in the Club premises may expose me to certain risks including but not limited to being contracted with any of the said infectious diseases due to circumstances that are unforeseen and/or beyond management's control.

      3. I knowingly and freely assume all such risks, both known and unknown, and assume full responsibility.

      4. I will comply with the safety and health protocols being implemented by Management.

      5. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release and hold harmless the Makati (Sports) Club, Inc., its Directors, Officers, employees, agents and fellow Club members, with respect to any and all illness, disability, deaths, or loss or damage to person to the fullest extent permitted by the law.

      I have read this release of liability and assumption of risk agreement, fully understand its terms, understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement.

      I hereby authorized Makati (Sports) Club, Inc., to collect my data indicated herein for the purpose of effecting control of the COVID-19 infection. I understand that my personal information is protected by RA 10173, Data Privacy Act of 2012.