City of Independence Gathering Protocol
Gathering/Event Name
Gathering Date(s)
Gathering Location/Address
Contact Person/Responsible Party
First Name
Last Name
E-mail of Contact Person
example@example.com
Contact Person Phone Number
-
Area Code
Phone Number
What is the normal occupancy for the space being used for the gathering?
What is the proposed maximum occupancy for your gathering?
What is the square footage of the space?
How will you ensure social distancing and mask wearing during your event/gathering?
Which of the following has been done?
All employees/volunteers have been told not to come to work if sick
Health screenings are conducted before employees/volunteers begin work
Break rooms, bathrooms, and other common areas are disinfected frequently
Hand sanitizer and hand washing areas are available to all volunteers/employees/guests
Disinfectant and cleaning supplies are available to all employees/volunteers
All guests have been told not to attend if sick
All employees/volunteers and guests have been told that a mask is required
All employees/volunteers and guests have been told of the need to social distance
What other steps are being taken to ensure the health of employees, volunteers, and guests at the gathering?
How will you ensure guests, staff, and volunteers can be notified after an event if an individual later tests positive?
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