Culver City Plunge Pool – Proof of Vaccination

By order of the 38th Supplement to Public Order under the City of Culver City emergency authority, proof of Covid-19 vaccination is required to enter certain indoor businesses and indoor city facilities effective November 29, 2021, for individuals 18 years of age or older.

Starting on November 29, 2021, adults age 18 and over will need to show proof of vaccination (or show proof of a negative COVID test within the previous 72 hours of their lesson) in order to attend swim lessons at the Culver City Plunge pool.

Culver City is requiring One with the Water to obtain information of your proof of vaccine and, therefore, we ask that you provide us with your vaccination status via this website or an email.

At this time, we are not asking for you to send us a digital copy of your vaccine status, but please make sure you have a copy handy for the Culver City Plunge. In accordance with the Culver City Plunge, you will not be able to attend lessons until this form has been completed. We will always and only comply with the United States Constitution and United States HIPAA laws.

Please provide answers to the below no more than 72 hours in advance, but at least one day before your swim lesson.

You may obtain your digital vaccination card by clicking the following link and filling out the information at California’s Digital COVID-19 Vaccine Record Portal.

Thank you for your understanding and cooperation.