UUCSJS Participation Health Pledge

Please complete this form before attending any UUCSJS gathering. Make sure you click submit when finished.
 
 
 
As a member or friend of UUCSJS and a participant in our programs, I attest to the following:


* I have not tested positive for COVID-19 in the past 10 days.


* If I previously tested positive for COVID-19, it has been at least 7 days after symptom onset and at least 48 hours after the resolution of any fever (without the use of fever-reducing medications), and I have been cleared by a medical provider.

 

* If I previously tested positive for COVID-19 (regardless of symptoms), I have quarantined for 5- 10 days after the last positive test per CDC protocols

 

* I have not been within 6 feet for 10 minutes or longer of a person that I am aware has tested positive for COVID-19 in the past 10 days.

 

* I am not experiencing (ANY NEW) below symptoms related to COVID-19:

fever, chills, rigors, myalgia, headache, difficulty breathing, new or worsening cough, sore throat, nausea or vomiting, diarrhea, fatigue, congestion or runny nose, new loss of taste or smell

 

* I am not under quarantine as directed by a healthcare provider, or subject to a Federal, State, or local quarantine order related to COVID-19.

 

I agree that I will not come to face-to-face gatherings with members and friends of UUCSJS at our building or auxiliary locations (including outside gatherings) for any reason if any of the above changes.

 

To protect the health and safety of the UUCSJS community, I agree to abide by the UUCSJS COVID-19 Safety Plan, including mask wearing, handwashing procedures, and social distancing.

Please select one option.

Description

Please complete this form before attending any UUCSJS gathering. Make sure you click submit when finished.