COVID PROTOCOLS

Everyone who registers will also need to complete this form. This is mandatory.

* Indicates required field

Name *

First

Last

Email *

School *

Have you or anyone you know been in contact with someone that tested positive for Covid-19 in the last two weeks? *

Yes No

Have you or someone you know tested positive for Covid-19 in the last two weeks? *

Yes No

Have you or anyone you have been in contact with experienced any of these symptoms: Fever, coughing, sore throat, diarrhea, vomiting, trouble breathing, new loss of taste or smell or flu like symptoms in the last two weeks? *

Yes No

By answering these questions and signing this document you are acknowledging and agreeing that all information provided was given voluntarily and accurately to the best of your knowledge. If you answered yes to any of these questions this could be used to deny you entry to the 417 Collegiate retreat. We thank you for your cooperation in keeping this retreat as healthy and safe for all students and staff involved. Please print your name below and it will be considered your signature. *

Submit