COVID Vaccinations 12-15
Good Afternoon Fairmont Families,

Fairmont will be providing COVID vaccinations on next Thursday for children ages 12-15. We need to get an estimated number of children that want the vaccination. If you would like your child to receive the vaccination, please complete the form below, no later than Monday, May 17, 2021.

Will County Department of Health will provide permission slips for sign up. We will contact parents/guardians that express an interest in having your child(ren) vaccinated.

Please complete a separate form for each child.
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Child's First and Last Name *
Age of Child *
Parent/Guardian First and Last Name *
Parent/Guardian Phone Number *
Parent Email Address *
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