COVID-19 Pfizer Vaccine Clinics for New Kent Students, Ages 5-11, Nov. 29, 2021
Please indicate your interest in having your child participate in a Pfizer COVID-19 vaccination clinic (for those ages 5-11 ONLY) to receive either a 1st or 2nd dose. Parents or guardians must accompany all children receiving the vaccine. Please complete this survey at least 24 hours prior to the event date. The event location has a maximum capacity, so we might need to close sign-up early if it fills up quickly. Also, we recommend short sleeves for the person being vaccinated (of course, under a jacket/warmer layer) so we can more easily vaccinate.
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Email *
Parent/Guardian Phone Number
First Name of Child *
Last Name of Child *
My child's home/zoned school is: *
I would like for my child to receive a Pfizer vaccine: *
All clinics will take place at New Kent High School. Please select the time your child will attend. All clinics are open to students 5-11. We will do our best to accommodate appointment time choices but we can not guarantee a time. A confirmed appointment time will be emailed to you by the morning of the clinic. All children must be accompanied by a parent/guardian. *
School administration will provide vaccine consent forms and  fact sheets. Thank you!
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