Travel Camp Questionnaire Form - Village of Rye Brook

Name * Required
Date * Required
Email Address * Required
Phone Number * Required
Does your child have a temperature of 100.00 degrees Fahrenheit or higher? * Required
Does your child feel feverish or are they experiencing chills or symptoms of a lower respiratory illness such as cough, shortness of breath or difficulty breathing? * Required
Has your child traveled to an area with known local or international spread of Covid-19 in the past 10 days? * Required
Has your child come into contact in your residence (within 6 feet) with someone who has a suspected or confirmed case of Covid-19 diagnosis in the past 10 days? * Required