This clinic is scheduled for WEDNESDAY, FEBRUARY 9 AT 6:30PM AT FLEET FEET FOX VALLEY. It is limited to 10 participants.

By filling out this form, I certify that I will only attend the clinic on the date noted above if (1) I have not traveled out of the country or been in close contact with anyone who has traveled out of the country within 14 days of the clinic; (2) I have not had close contact or cared for someone diagnosed with COVID-19 within 14 days of the clinic; (3) I have not experienced any cold or flu-like symptoms (cough, fever, headaches, muscle aches, rashes) within 14 days of the clinic. I agree that if any of these statements are not true and accurate as of date of the GFR Clinic, I cannot and will not participate in or be present.