SPUR · Covid Attestation Form

Name

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First Name

Last Name

Email

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Verify Email

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Address

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City

State/Province

ZIP/Postal Code

Protocol

In following CDC and Board of Health best practices, it is required that when preparing food you wash your hands for at least 20 seconds with warm soapy water and disinfect surfaces before meal preparation.

Masks and gloves are required for food prep of non-cooked items (salad, fruit, sandwiches, pasta salad, etc.)

For best practices, masks and gloves are strongly recommended for heated meals.

Do you or any volunteer participating in meal prep have a cough?

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Do you or any volunteer participating in meal prep have a sore throat?

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Are you or any volunteer participating in meal prep experiencing rapid breathing or shortness of breath?

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Are you or any volunteer participating in meal experiencing diarrhea, nausea, vomiting?

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Do you or any volunteer participating in meal prep have a headache?

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Are you or any volunteer participating in meal prep experiencing new loss of smell or taste?

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Do you or any volunteer participating in meal prep have a temperature above 99 degrees F?

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Have you or anyone participating in meal prep been in contact with anyone who has tested positive for Covid-19 in the last 14 days?

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Have you or anyone participating in meal prep traveled to/from a State or Country in the last 14 days with restrictions based on MA current guidelines?

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Agreement

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I, the Participant, understand and acknowledge the importance of adhering to rigorous cleaning and sanitary best practices for meal prep, especially during Covid-19. I hereby state that I am, and minors with whom may participate with me, are healthy and we have no symptoms, nor have tested positive or been exposed to someone who has in the past 14 days. I will prepare food in compliance with the public health requirements set by the Marblehead Board of Health, CDC and Massachusetts Board of Health.

Agree

Decline