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COVID-19 Waiver

  • The Friendship Circle is strictly adhering to the CDC guidelines and taking all precautions to ensure a safe environment for all visitors. Every person who will partake in our programs is now expected to complete the health history form below, prior to arriving. We appreciate your cooperation during this time of the pandemic (COVID-19).

    Please complete this form so that we can ensure the health and safety of all participants. Please note, that although you won't need to fill the form out before attending every program, this applies every time you are participating in a Friendship Circle program throughout the entire year.

  • If the answer is "YES" for me or a member of my family as described below at any given day, I understand that we cannot participate in the Friendship Circle activities:

    -Do you or your child have any symptoms, such as a temperature greater than 100 degrees, dry cough, difficulty breathing, fatigue, upset stomach or sore throat?

    -Is anyone in your household ill with symptoms including a temperature greater than 100*, dry cough, difficulty breathing, fatigue, upset stomach, or sore throat?

    -Have you or your child had COVID-19 or has come into contact with anyone who has tested positive for COVID-19 in the last 14 days?

    -Has any of your household members traveled outside of the country or to any city considered to be a "hot spot" for COVID-19 infections within the past 14 days?

  • Waiver:

    ·      I understand the above symptoms and affirm that I, as well as all household members, will not attend FC programs if we have experienced the symptoms listed above within 14 days of a program.

    ·         I understand that Friendship Circle of Fairfield County cannot be held liable for any exposure to the COVID-19 virus caused by misinformation on this form or the health history provided by each visitor.

    Our organization is following these enhanced procedures to prevent the spread of COVID-19:

    ·         Building use - temperature will be taken before entering the building and those that have a fever will not be able to participate.

    ·         Face covering protocol; volunteers, parents, instructors, and staff are required to wear a face mask when in the building. When outdoors, as long as visitors are keeping a social distance of 6 feet apart, they are not required to wear a face mask.

    ·         Maintain social distancing of 6 feet apart at all times.

    ·         Wash hands / sanitize frequently.

    ·         Disinfect areas as they are used.

    ·         Clean building daily including light switches, door handles, other common areas.

    By entering my initials below, I agree to each statement above and release The Friendship Circle of Fairfield County from any and all liability for unintentional exposure or harm due to COVID-19.

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