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VALLEY TRAILS CAMP
COVID DECLARATION. Please complete by Sunday 9 pm the week before your child attends Valley Trails Camp.
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1
Date
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Date
Month
Day
Year
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2
Campers Names
Fill out Campers Name, Last Name then First Name
Camper 1 Name (Last Name, First Name)
Camper 2 Name (Last Name, First Name)
Camper 3 Name (Last Name, First Name)
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3
Camper Names
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Add row for multiple campers
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4
COVID DECLARATION SURVEY
*
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If yes to any question, please do not send your camper to Valley Trails for 24 hours or if experiencing COVID, contact doctor.
Yes
No
Have you traveled in last 14 days to area identified by the CDC as Level 3?
Do you have any of these symptoms: Cough, sore throat, fever, upset stomach,runny nose?
Have you been around anyone who has tested positive for COVID?
Did your camper take any fever reducing medication in last 24 hours?
Have you traveled in last 14 days to area identified by the CDC as Level 3?
Do you have any of these symptoms: Cough, sore throat, fever, upset stomach,runny nose?
Have you been around anyone who has tested positive for COVID?
Did your camper take any fever reducing medication in last 24 hours?
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No
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5
COVID Declaration Terms and Conditions
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Please review terms and condition of Declaration. Your camper may be sent home if the Declaration is not filled out before attending camp.
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6
Parent/Guardian Name
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First Name
Last Name
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