COVID-19 Travel Form

COVID-19 VERMONT TRAVEL ATTESTATION AND PROTOCOLS AGREEMENT

I attest that on each day I am participating in or in contact with Vermont Adaptive Ski and Sports (Vermont Adaptive) programs or spaces and at Partner Resorts

  1. I will either have not traveled out of State in the 14 days prior to being at Vermont Adaptive programs and partner resorts or that I will be in compliance with the Vermont Cross State Travel/Quarantining Guidelines as found at https://accd.vermont.gov/covid-19/restart/cross-statetravel.
  2. I agree I will not have been in close contact with a person that has tested positive for COVID-19 within the 14 days prior to being at Vermont Adaptive or partner resorts.
  3. I agree I will not come to Vermont Adaptive or partner resorts if I have any of the following COVID-19 health symptoms: fever of 100.4F or greater, coughing, shortness of breath, chills, fatigue, muscle pain or body aches, headache, sore throat, loss of taste or smell, congestion or runny nose, nausea, vomiting or diarrhea.
  4. I agree to maintain 6' of physical distancing from those not in my traveling party/household.
  5. I agree to wash my hands and/or sanitize them often.
  6. I agree to wear a face covering or mask at all times where required at Vermont Adaptive and at partner resorts.

Failure to comply with any of these COVID 19 requirements may result in the loss of Vermont Adaptive and Resort privileges for the remainder of the season.


*** COMPLETE FORM BELOW or DOWNLOAD FORM HERE ***


Full Name (required)

Your Signature (required)

Date (required)



I certify that all persons in my care who are under the age of 18 or who are dependent on my
care meet the requirements specified above.


Their full names and date of birth are:

Note - DOB format: MM/DD/YY

Full Name

DOB


Full Name

DOB


Full Name

DOB


Full Name

DOB


Full Name

DOB



Household Contact Information

E-mail

Phone

Address

Home Program Location


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