Common Contracts
1 similar Health and Safety Agreement contracts
Retreat Group Health and Safety AgreementHealth and Safety Agreement • May 29th, 2020
GUEST INFORMATION (ONE FORM FOR EACH PERSON ATTENDING) First and Last Name Name of Group or Retreat Attending 1. I have not been around anyone with any of the listed symptoms or diagnosis of COVID19 in the 14 days before the start of retreat. Initial Mailing Address City, State, Zip Best Phone Number to Reach You Date of Birth PARENT AND EMERGENCY CONTACT INFORMATION 2. No one in our household has been sick in the 14 days prior to retreat. Initial 3. I have adhered to our state’s guidelines regarding COVID19. Initial Parent(s) First and Last Name(s) Complete only if under 18 Mailing Address City, State, Zip Home Phone Cell Phone E-mail Address Emergency Contact Name if Parent/Guardian unavailable Phone of Emergency Contact HEALTH HISTORY AND MEDICAL INFORMATION Allergies: Food/Medications/Insects/Other Dietary Concerns/Restrictions Other Health Issues HEALTH AND SAFETY AGREEMENTAlthough the fullest safety and health precautions are taken, Metigoshe Minis
