Pfizer Vaccine Clinic Sign-Up

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A Pfizer Vaccine (2 dose) clinic for individuals 12+ years or older will be held on the campus of the Ralph C. Mahar Regional School, in the gymnasium, on Friday, May 28, 2021 from 2:15 PM - 4:00 PM with the second dose being distributed on Friday, June 18, 2021.

You do NOT have to be a student enrolled at the Ralph C. Mahar Regional School.

Community members 12+ YEARS and older are welcome to attend.

You MUST register for this clinic.

Please complete a form for EACH individual who will be participating in the vaccine clinic.

Please note, all children MUST be accompanied by a parent or guardian.

Consent forms MUST be completed PRIOR to arriving for the vaccine.

CONSENT FORM: https://drive.google.com/file/d/16JMwRWBjNTOOD5eZIBLV4aHVLgAfxjE3/view?usp=sharing

VACCINE FACT SHEET: https://drive.google.com/file/d/16QazvUe7C6_L9qEmVIRMZvvDjUtouH-A/view?usp=sharing

Email *

Last name of the individual receiving the vaccine *

First name of the individual receiving the vaccine *

Please choose a time slot from for Friday, May 28, 2021; the second vaccine in the series will be Friday, June 18, 2021. Please note, both vaccines will be for the same time selected. *

A copy of your responses will be emailed to the address you provided.

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