Open Streets COVID-19 affirmation
In order to confirm your scheduled shift, persons participating in the operation of the Vanderbilt Avenue or Underhill Avenue open streets must complete the following form for compliance with City COVID-19 safety regulations. This form must be completed by all staff and volunteers prior to the start of their shifts.
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Date of your shift *
MM
/
DD
/
YYYY
Your name *
Your mobile phone number *
Your email address *
COVID-19 self certification *
For information about the symptoms of COVID-19, see https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html. Please confirm that you have not within the last 14 days
Required
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