WOLCA Daily Screening

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WOLCA Daily Screening

Reminder: If you have traveled out of state for over 24 hours you must show proper documentation (Neg covid tests) prior to coming in to school. This form is to be filled out daily for each WOLCA family.

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Please list your child(ren) attending summer camp today.

Parent or Guardian's Name *

I attest that my child or children listed above, are not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell. *

I confirm the statement above as true.

I attest that my child has not travelled out of the state of New York. If they have, we have followed the NEW NYS Guidance for traveling outside of the state and have provided the school with the appropriate documentation. *

I confirm the statement above as true.

I do not believe I or my family have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19. *

I confirm the statement above as true.

I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19. *

I confirm the statement above as true.

I or a member of my household have not been diagnosed with Coronavirus/Covid-19. If we have, we have been cleared as non contagious by state or local public health authorities. *

I confirm the statement above as true.

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