Guest and Visitor Safety Acknowledgement to COVID-19 Pandemic Guidelines
Email *
By completing below as a guest or visitor of Salem Academy and College (“Salem”), I acknowledge and agree that:

• I have carefully read and agree to follow Salem’s guest and visitor guidelines applicable during the COVID-19 pandemic;

• I have carefully read and agree to complete the Daily COVID-19 Screening Checklist [] and to follow Salem’s Isolation and Quarantine Requirements [] prior to campus entry; and

• I will not enter campus if my responses to any of Questions 1–6 on the Daily COVID-19 Screening Checklist are “Yes” on the day(s) of my scheduled campus visit(s). In this situation, I will notify my Salem contact and reschedule my campus visit(s) after receiving clearance from Salem in accordance with Salem’s Isolation and Quarantine Requirements.
Name *
Type your name here to confirm your agreement to abide by this Guest and Visitor Safety Acknowledgement:
Enter today's date *
Contact number *
Salem Contact Person or Department *
* For minor visitors and guests (under 18 years of age), please print the name of the minor child and a parent or guardian signature is required.
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