2021 Camp Health Screening
Mandatory for all attendees to complete EACH day they attend
* Required
Last, First Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Email Address
*
Your answer
Phone number
*
Your answer
Which of the following best represents you?
*
Choose
Brass/Brass Staff
Color Guard/Color Guard Staff
Percussion/Percussion Staff
Drum Major
Administration/Support Staff/Other Staff
Event which you are participating in
*
Choose
Brass Rehearsal, 4/10, Stutson St
Guard Rehearsal, 4/10, Wilson School
Front Ensemble Rehearsal, 4/11, Bingo Hall
Do you currently have (or have had in the last 10 days) one or more of these new or worsening symptoms? A temperature equal to or above 100 degrees F; Feel feverish or have chills; Cough; Loss of taste or smell; Fatigue/feeling of tiredness; Sore throat; Shortness of breath or trouble breathing; Nausea, vomiting or diarrhea; Muscle pain or body aches; Headaches; Nasal congestion/runny nose.
*
Yes
No
In the past 10 days, have you tested positive for COVID-19 or have you been tested for COVID-19 and you are still waiting for the result?
*
Yes
No
In the last 10 days, have you been designated a contact of a person who tested positive for COVID-19 by a local health department?
*
Yes
No
In the last 10 days, have you traveled internationally to a CDC Level 2 or 3 COVID-19 related travel health notice country? Further information on the NYS travel advisory can be found at
https://coronavirus.health.ny.gov/covid-19-travel-advisory
*
Yes
No
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