Simcha Event and Out of State Travel Form
With the growing need for vigilance against the spread of COVID-19 within our communities, we require Mesivta families to inform us of simcha events they plan to attend in order to see if a quarantine following attendance is required.  In addition, while Governor Wolf's travel ban has been lifted, travel can often lead to compromised COVID situations; therefore, disclosing situations that open the school to risk is essential.  Please fill out the simcha and travel form with the pertinent information for the school with at least 3 days advance notice, so that we can assess the details and guide you.  Please provide as much information as possible so that we can evaluate the event fully; if after attending, you feel that the information was not consistent with the form, please contact the school for updated guidance.
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 Name(s) of the student(s) or staff member filing the request: *
The simcha event is a
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The date of the event is_______ and the duration is ______.
A description of where the event will occur (ex: indoors with HVAC, indoors with windows open, outdoors, in a tent, etc)
The size of the event is approximately
Please describe the masking and distancing steps that will be in place.
For Simcha event: Please describe the food and seating situation, if applicable. (ie buffet, plated, passed hors d'oeuvres, seats 6 ft apart, family tables etc).
Will this event/travel involve sleeping over somewhere outside of your home? If yes, please elaborate (ie staying in someone's private basement, hotel, in-house with cousins, etc.).  If vaccinated/travel companions area vaccinated, please disclose.
The event/travel takes place _____ (insert community/city and state)
If not a simcha, are you traveling out of town for other purposes?  If yes, please explain.
Regarding travel, how many unvaccinated individuals traveled together from outside of your household?  
Please provide any additional details that you would like to share:
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