Kids Club Check In
How many Kids are you checking in today?
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1
2
3
4+
Child # 1 Name
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Child # 2 Name
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Child # 3 Name
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Child # 4 Name
*
Parent or Guardians Name
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Contact Number
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Where in the Facility will you be today?
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Allergies or Special Needs?
Please answer the following questions prior to checking into Kids Club
My Child has had no new or worsening cough, experienced a fever in the last 72 hours, had shortness of breath, or been in a household with anyone diagnosed with Covid-19 in the last 14 days
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Yes
No
I verify that my child is free of illness, and able to participate in Kids Club activities. I understand that SHC is following the recommended guidelines provided by the CDC and OHA due to COVID-19.
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I understand the risks of participating in indoor group activities and participate willingly.
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Send me a copy of my responses
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