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Please fill out the following form in order to participate in our activity.

Have you tested positive for COVID-19 in the past 10 days?
Have you had a fever (100.0°F or greater) in the last 24 hours?
Have you had close contact with someone with a confirmed positive COVID-19 in the past 10 days?
If you have traveled out of the country within the last 10 days, did you get a negative COVID test result taken between 3 to 5 days after arrival and quarantined for 7 days?
Do you currently have any of the symptoms below? ● Fever (100.0°F or greater) or chills ● Congestion or runny nose ● Cough ● Sore throat ● Fatigue ● Headache ● Muscle or body aches ● Shortness of breath or difficulty breathing ● New loss of taste or smell ● Nausea or vomiting ● Diarrhea
If you answered YES to any of the questions above, you are NOT allowed to enter the building.

Your signature below indicates that you have answered the above questions truthfully

Thanks for submitting!

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