Summer Day Camps in Manor Park: Pre-Program Declaration of Participant Health
All parents / guardians must complete this form on behalf of their child (the participant), before their first day of attendance at Summer Day Camps in Manor Park. A separate form must be completed for each child attending.
Child's First & Last Name (Participant) *
Name of parent / guardian completing the declaration of health on behalf of the child. *
Child's start date at Summer Day Camps in Manor Park *
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Do you confirm that the participant or any member of your household has NOT experienced any of the following symptoms in the past 14 days: cough / difficulty breathing / fever / muscle aches / headaches / chills / loss of taste or smell / sore throat / difficulty swallowing / diarrhea / disorientation / sleeping more than usual / nausea / vomiting / dizziness. *
Do you confirm that the participant has NOT experienced any of the following symptoms in the past 14 days: rash / prolonged fever / red eyes / abnormal swelling of hands or feet. (If the participant has experienced any of these symptoms, a doctors note is required to attend the camp.) *
Required
Please check all that apply: *
Required
Please check all that apply: *
Required
Notice of Risk: When children from multiple families attend a day camp, there is an increased risk of the Covidk-19 virus coming into camp. Children who are infected with Covid-19 virus are more likely than adults to have very mild infections or to have no symptoms at all, but these children can still transmit the infection to other children and to adults at camp. This means that children can bring home an infection acquired in a camp and put other persons at risk. Even if a day camp has a screening process to help detect infections when there are no symptoms, this screening process will not detect infected children or adults who do not have symptoms at the time of screening.
I confirm that I have read and understand all of the above, including Notice of Risk, that I have read the Summer Day Camps in Manor Park Parent Handbook and agree to complete the Active Screening Questionnaire for participant before arrival at camp each day. *
Required
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