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2022 Youth Camps Proof of Vaccination or Negative Test
Student Information
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First Name
Last Name
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COVID-19 Vaccine Definitions

All camp attendees are required to either be Up to Date on COVID-19 vaccines or submit results of a negative COVID-19 test taken within 72 hours of the beginning of the camp. Up to Date means a person has received all recommended COVID-19 vaccines, including any booster dose(s) when eligible. For more information about COVID-19 vaccine definitions and eligibility, see Stay Up to Date With your Vaccines on the CDC’s website.

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Acceptable proof includes 1.) A photo of a vaccination card (including name of person vaccinated, type of vaccine provided, and date last dose administered); or 2.) Documentation of vaccination from a healthcare provider, electronic health record, or state Immunization Information System record.

Acceptable test results include, a negative COVID-19 molecular lab test (PCR or NAAT) taken no more than 72 hours prior to the start of the camp. Test results must come from a testing agent (a laboratory, health care provider, or pharmacy). Self administered at-home rapid tests will not be accepted.

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Acknowledgements

I certify that I am the legal guardian of the student named above and that I have read and understand ShoreLake Arts’ COVID-19 Vaccination Policy for this camp. I also acknowledge that failure to complete this form prior to the camp(s) for which my student is registered, or providing false or misleading information on this form may result in my student’s dismissal from the camp(s) for which they are registered with refunds subject to the Cancellation & Refund Policy.

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First Name
Last Name
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