HGKFLD Academy: COVID Attendance Clearance
*Make sure to fill this out on the same day before you leave to come to the school! If it is not the same day then you will be asked to fill it out again before entering*
All students and instructors will have to complete this clearance form to be able to attend class. Temperatures will also be checked at the door. Thank you for taking the time to complete this form and following our new procedures.
Please write your full name (first and last name)
Please put in the date and time that you are completing this form. *Any forms completed before the class date will not be accepted*
Are you experiencing any of the following symptoms?
Shortness of breath
New loss of smell or taste
New nasal congestion or new runny nose (not related to seasonal allergies)
New cough (not related to chronic condition)
Fever or feeling feverish
Have you had contact with a COVID positive person within the last 14 days.
Yes (I have had contact)
No (I have not had contact)
I am wearing my uniform which has been cleaned and washed since the last time I have worn it.
I have my mask with me and will have it on while at the school and during class.
I will wash my hands when entering and leaving the school and sanitize them as needed.
I understand I have to avoid physical contact and keep my distance from others.
By checking "I agree" you attest to the statement below.
By checking "I agree" below, I confirm that the questions answered above are answered fully and truthfully to the best of my ability as the student or as their guardian. I also attest that we have read, understand, and follow the COVID Protocols.
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