Summer Camp Health Screening

Health Screening Checkpoint
Summer Camp 2020

Important Information

This form should only be filled out the day before your scheduled week of Summer Camp begins. We will adjust the camp week as it becomes applicable.

If you answer “yes” to any of the following questions in the Screening Questionaire below, your child’s participation in our camps could unfortunately be impacted.

In addition, a Daily health screening check point and log is required and will be implemented for all campers entering the studio during the camp week.

If you or anyone in your home has one or more symptom(s) that may be related to COVID-19, please stay home and we’ll work with you to reschedule your reservation.

Screening Questionaire

* Indicates required field

Child's Name *

First

Last

Sibling's name *

First

Last

Parent/Legal Guardian *

First

Last

Preferred Phone Number *

Email *

Camp Location *

Summer Camp Week *

Do you have anyone in your home interacted with anyone that is at a higher risk for contraction? (nurses, essential workers, etc.)

Yes or no? *

Yes No

Do you have anyone in your home that could be more susceptible to contracting COVID-19?

Yes or no? *

Yes No

Have you had anyone in your home had contact with a person known to be infected, potentially infected, or exposed to someone infected with COVID-19 within the previous 14 days?

Yes or no? *

Yes No

Have you had anyone in your home or someone you’ve been in contact with traveled domestically or internationally in the last 14 days?

Yes or no? *

Yes No

Have you had anyone in your home or someone you’ve been in contact with attended a gathering where proper social distancing protocol was not followed in the past 14 days?

yes or no? *

Yes No

Have you had anyone in your home had a fever, cough, shortness of breath, difficulty breathing, chills, muscle pain, sore throat, or new loss of taste or smell that cannot be attributed to another health condition in the past 2-14 days?

yes or no? *

Yes No

Please acknowledge the following: *

I certify that all answers are true and correct to the best of my knowledge on behalf of my child(ren) and family.

⚠️ COVID-19 Disclaimer:
We have taken enhanced health and safety measures for all our customers and staff. You must follow all posted instructions while visiting our studio.

In any public place where people are present, there is an inherent risk of exposure to COVID-19. This is an extremely contagious disease that can potentially cause severe illness and death.

According to the Centers of Disease Control, senior citizens and those with underlying medical conditions are especially vulnerable. By visiting Happy Hands you voluntarily assume all risks related to exposure to COVID-19.

Together, we can help keep each other safe and healthy.

Agree to terms? *

I have read and agree to the follow terms and conditions.

Signature *

Date (MM/DD/YYYY) *

Submit

We're OPEN with limited hours. Due to limited seating, reservations highly recommended.

Register today for Summer Camp 2020! Week 1 starts June 29th!

Health Screening Checkpoint
Summer Camp 2020

Important Information

Screening Questionaire

We're OPEN with limited hours. Due to limited seating, reservations highly recommended.

Register today for Summer Camp 2020! Week 1 starts June 29th!

Health Screening Checkpoint​Summer Camp 2020

Important Information

Screening Questionaire

Health Screening Checkpoint
Summer Camp 2020