Daily Screening Checklist
Please fill out this questionnaire every day your child comes to school at Majestic Harbor prior to entering the building. Children with a YES answer to any question will not be allowed to enter. Discovery of any untruthful answers may prevent future attendance to Majestic Harbor.
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Today's date *
MM
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DD
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YYYY
Child's name *
Caregiver name *
Today or in the past 24 hours, have you or any household member had any of the following? *
In the past 14 days, have you had close contact with a person known to be infected with the novel coronavirus (COVID-19)? Close contact is defined as being within 6 feet of an individual who has tested positive for COVID-19 for more than 10 minutes while that person was symptomatic, starting 48 hours before their symptoms began until their isolation period ends? *
I certify that my responses to the above checklist are accurate and truthful. *
Required
Do you authorize your child to use hand sanitizer with at least 60% alcohol diluted with water under staff supervision? *
Pick-up time *
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