Kirkland Concert Band rehearsal attendance
for the rehearsal of October 2, 2022
Sign in to Google to save your progress. Learn more
Vaccination Proof
To attend indoor rehearsals, you must provide proof of full vaccination.
name: *
phone number: *
instrument: *
Covid-19 contact questions: *
Required
Covid-19 symptoms:
new or worsening cough
shortness of breath or difficulty breathing
temperature  equal to or more than 38°C
feeling feverish
chills
fatigue or weakness
muscle or body aches
new loss of smell or taste
headache
gastrointestinal symptoms (abdominal pain, diarrhea, vomiting)
feeling very unwell

[ from https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/symptoms.html ]
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy