SPRING 2021 PARADE OF HOMES

#PARADEOFHOMESMB

COVID-19 SHOW HOME PRE-SCREENING DECLARATION FORM

PART 1:

This declaration is made in connect with my/our attendance of:

PART 2: 

I/WE confirm the following statements to be true(check all that apply):

COLUMN A SYMPTOMS(one symptom)

  • Fever/Chills

  • Cough

  • Sore throat/hoarse voice

  • Difficulty breathing

  • Loss of taste or smell

  • Vomiting or diarrhea for more than 24 hours

COLUMN B SYMPTOMS(two symptom)

  • Runny nose

  • Muscle aches

  • Fatigue

  • Pink eye(conjunctivitis)

  • Headache

  • Poor feeding, if an infant

  • Nausea or loss of appetite

PART 3: 

I/WE acknowledge and agree that:

To the best of my knowledge everything contained herein is true, and this declaration may be relied upon as having the same force and effect as if made under oath.

Thanks for submitting!

PLEASE BOOK YOUR PRIVATE VIEWING WITH JENNIFER GULAY

204-794-9464

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