COVID-19 Vaccination Status

COVID-19 Vaccination Status
I confirm my understanding and agreement that my full and complete COVID-19 vaccination is a requirement for my participation in a Big Round World trip.
Name *

First Name Last Name
Email *
example@example.com
The following represents my COVID-19 vaccination status: *

Fully vaccinated. Upon request, I will provide a copy of my COVID-19 vaccination card.
Date scheduled for my booster COVID-19 vaccine is: *

Month Day Year
Date
I would like to sign up for the following Big Round World tour blanks* .
Signature *

Clear
On a touch-screen, use your finger to sign. Otherwise, use your mouse to sign.
Enter today's date *

Month Day Year
Date
Please verify that you are human *
Should be Empty: