August 6, 2021 Pfizer Vaccine Clinic at Grand Valley Local Schools

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All GV students, staff members and their families are welcome to register to receive the two dose Pfizer vaccine. The first dose will be administered on August 6th at 2:00 in the GV auditorium. The second dose will be administered on August 27th (time will be given closer to the date of the event). Please complete the Google Form for each person receiving a vaccine to register for the event.
Must be 12 years of age or older at the time of the first vaccine. Students must be accompanied by a parent for the first vaccine or a Consent to Administer COVID- 19 vaccine form must be completed.
Vaccine is free. No insurance information needed.
A Consent to Administer COVID- 19 vaccine form may be emailed to you upon request.
Please email Nurse Esquivel with any questions elizabeth.esquivel@grandvalley.school

Name of the person receiving the vaccine

The above name is a:

Current student

Staff member

Family member of a current student or staff member

Clear selection

The above named individual is at least 12 years of age on August 6, 2021

Yes

Clear selection

Please indicate the primary telephone number to receive event information

Please indicate your primary email to receive event information

Submit

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