Covid-19 Safety Questionnaire
- Has your child or anyone in your household had a fever higher than 100 degrees in the past 14 days?
- Has your child been administered any medication to reduce his/her fever?
- Has your child or anyone in your household had any of the following symptoms: coughing, chills, body aches, difficulty breathing within the past 14 days?
- Is your child or anyone in your household in the AT RISK category as outlined by the CDC (respiratory issues, compromised immune system, etc)?
By signing this form I am agreeing that I have been honest in answering these questions and following all the listed virus protocols in order to ensure the safety of Play Date of New Bern (Bear City Play Date, LLC). I am agreeing that I have answered NO to all the above questions. I understand that by being dishonest or not following the safety protocol, I/my child will be prohibited from using this service. In addition, I acknowledge that I am assuming all potential risk in the event that my child or someone in my household becomes sick.