Village Kids' Sunday School Health Check

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Health check-in to be complete morning before attending Sunday school. This form is for parents whose children plan to participate in Sunday school. This for must be filled out for each time your child participates in Sunday school or any other Village Kid event.

Child's First and Last Name *

Date of Event *

Have you experienced any of the following symptoms in the past 24 hours: Fever (100.4 F or higher), Chills (or shaking chills), Cough, Shortness of breath or difficulty breathing, Fatigue (feeling tired), Muscles or body aches, Headache, New loss or decrease of taste or smell, Sore throat, Congestion or runny nose, Nausea or vomiting, Diarrhea? *

Yes

Have you been diagnosed with COVID-19 in the past 14 days? *

Yes

Have you been in contact with anyone who has been diagnosed with COVID-19 in the past 14 days? *

Yes

**Answering "Yes" to any of the questions above requires your children staying home from Sunday school today. *If all answers are "No," then your children will be able to attend Sunday school today. *

YYYY

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