Grace Kids COVID19 Release Form

*Parents are required to have this form signed and submitted before their children can attend class.

As the parent/guardian of the following children,

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I confirm that I have read and will follow the Grace Kids Minimum Standard Health Protocols as follows:

I will screen my child each Sunday to ensure they do not exhibit any of the following signs or symptoms:

• Cough

• Shortness of breath or difficulty breathing

• Chills

• Muscle Pain

• Headache

• Sore throat

• Loss of taste or smell

• Diarrhea

• Feeling feverish or a measure temperature greater than or equal to 100.0 Farenheit

• Known close contact with a person who is lab confirmed to have COVID-19

If my child exhibits COVID-19 symptoms as outlined above I will seek COVID-19 testing and report any positive results to the Children’s Ministry Director.

I agree to notify the Children’s Ministry
Director and keep my child at home if my child has had contact with an
individual with a lab confirmed case of COVID-19. In addition, I agree to keep
my child at home if they have had fever, vomited or had diarrhea within 24
hours of camp.

Parent/Guardian Signature
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