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Team Vaccinate
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Email
*
Your email
Student's Last Name
*
Your answer
Student's First Name
*
Your answer
Name of Parent/Guardian Completing Form
*
Your answer
My student:
*
Received the Covid vaccination
Has not received the Covid vaccination
Is under the age of 12 and is not eligible for the vaccination
My student is a member of:
*
Cross Country Team
Boys Soccer Team
Girls Soccer Team
Football Team
Cheer Team
Volleyball Team
Band
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