COVID-19 Screening Tool

Please complete before coming to camp. If you answer YES to any of the questions, you/your child are/is not eligible to attend/visit camp.

	Camper Staff Visitor
First Name:
Last Name:
Phone:
Email:
TAN #:
Parents' Name:
PLEASE CONFIRM:
1. Does the camper/staff/visitor have any of the following new or worsening symptoms?* Fever 37.8°C or higher, Cough, Difficulty breathing, Decrease or loss of taste or smell, Feeling unwell, Sore throat or difficulty swallowing, Runny or stuffy/congested nose, Headache, Nausea, vomitting or diarrhea, Extreme tiredness or muscle aches? Yes No
2. Does anyone in your household have one or more of the above symptoms and/or is waiting for test results after experiencing symptoms? Yes No
3. Has anyone in your household travelled outside of Canada in the past 14 days? Yes No
4. Has anyone in your household been notified as a close contact of someone with COVID-19 or has been told to stay home and self-isolate? Yes No
5. Is the the camper/staff/visitor fully vaccinated? Yes No
6. Has the camper/staff/visitor been diagnosed with COVID-19 and recovered from COVID-19 in the last 90 days? Yes No
*Camper/staff/visitor who have an existing health condition identified by a health care provider that gives them the symptoms should not answer YES, unless the symptom is new, different or getting worse. Look for changes from your child's normal symptoms.
It is understood that Camp Tanamakoon is operating under the direction of the Covid Protocols developed by the Government of Ontario. We hereby wave any claim for damages and compensation for any loss whatsoever that may be caused by an outbreak of Covid 19 at Camp Tanamakoon.
Parents: please bring a copy of the camper's negative Rapid Antigen Test result to check-in at bus or landing.
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