Outright Vermont's Gender Creative Kids Outing to Audubon
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What is your name? *
For check in day of
How many adults will be attending in your group? *
Required
How many youth will be attending in your group? *
Required
What are the ages of the youth?
So we can be as developmentally appropriate as possible
What is your email? *
For contact tracing
What is your phone number? *
For contact tracing
Covid related questions
Outright Vermont will be hosting limited outdoor events with reduced attendance in accordance with Vermont State and Local Health recommendations. We ask that any community members attending any of Outright Vermont in-person events complete this form the evening before the event. You will be asked these questions and additional questions at the time of the event.

Outright Vermont and its programs are committed to our community's health & safety. We ask that no one attend in-person events if you are sick or symptomatic (with fever, cough, and/or shortness of breath), if you have traveled outside of Vermont within the last 14 days, if you have received a positive COVID-19 test result within the last 14 days, or if you have had contact with any other person who is diagnosed with COVID-19 within the last 14 days. When attending events please be mindful of frequent hand-washing or hand sanitizing, wear a cloth mask or covering (if you do not have one, please reach out to staff and we will provide one for you), and observe physical distancing of 6 feet or more with people that you do not live with.

For more information on COVID-19 prevention, please go to: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/index.html.

We will be collecting names and contact information and of those who attend Outright sponsored events. We will keep the information for a minimum of 30 days so that we may contact participants in the case of possible exposure to COVID-19. We will not share the identities of any group participants with any agency outside of Outright. We will not disclose the identities of any individual that tests positive for COVID-19.

Will you have traveled outside of Vermont in the 14 days before preceding October 11th? *
Have you been in close contact with someone who has traveled outside the state in the 14 days preceding October 11th?
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Do you have new or worsening onset of any of the following symptoms: fever, cough, shortness of breath, runny nose, chills, body aches, fatigue, headache, loss of taste/smell, eye drainage, congestion? * *
If yes what are your symptoms? (optional)
Have you been exposed to someone being tested for COVlD-19 or who has symptoms compatible with COVID-19? *
Are any members of your household or a close contact in quarantine for exposure to COVlD-I9? *
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