General Contact Information First Name and Last Name of Camper * First Name and Last Name of Person Completing the Form * Phone Number * Phone number of person filling out the questionnaire Camper Health Questionnaire What was your temperature today? * Have you been near someone with a confirmed case of COVID-19 recently? * YesNo Do you have a cough, shortness of breath, or a sore throat? * YesNo Do you have nausea or vomiting or diarrhea? * YesNo Do you have a new or worsening runny nose, nasal congestion or headache? * YesNo Have you recently lost your sense of taste or smell? * YesNo Do you have any reason to believe you or anyone in your household has been exposed to or acquired COVID-19 recently? * YesNo Do you have any health/wellness concerns for the Camper today? * YesNo MessageIf you would like to send a message, ask a question or make a suggestion, please use the two fields below. Message
