COVID-19 Reunion Declaration

Because of the current pandemic, known as COVID-19, we must be particularly vigilant to ensure the safety of our participants. Please carefully read this document, filling out each field. Each "Spousal Unit" also needs to fill out his/her own COVID-19 Declaration. Meanwhile, check CDC's Interim Public Health Recommendations for Fully Vaccinated People that are regularly updated as more data becomes available.

Initial Caps, please (John Doe), not ALL UPPER CASE (JOHN DOE) or all lower case (john doe)!

First name	Middle name/initial	Last name
Street Address	Town/City	State/Prov XX=2-letter code
ZIP	Country XX=2-letter code	Cell phone hyphens: 123-456-7890
E-mail	Confirm E-mail	COVID-19 Vaccination No/Yes, type, and date(s)
Emergency contact not with you	Relation to you (spouse, SO, friend)	Phone for emergency contact hyphens: 123-456-7890

Only one COVID-19 Declaration per person. I attest to the fact that for the 14 days immediately preceding the start of the workshop or reunion, I have:

Been following the scientifically-approved safe practices as outlined by CDC, including social distancing, proper wearing of masks, and avoiding all social gatherings;
NOT experienced symptoms of (please read carefully) (1) fever of 100.4°F (38°C) or higher, (2) cough, (3) shortness of breath or difficulty breathing, (4) chills, (5) muscle pain, (6) sore throat, (7) new loss of taste or smell, (8) fatigue, (9) body aches, (10) headache, (11) congestion or runny nose, (12) nausea or vomiting, (13) diarrhea, or (14) any other symptoms relating to COVID-19 or any communicable disease.

Out of respect for my fellow participants, if I exhibit any of the above symptoms, I will not attend the reunion and risk infecting others.
I promise to follow CDC guidelines during the reunion.
I will bring masks (and PM2.5 inserts if appropriate) and alcohol-based hand sanitizer wipes w/ at least 60% alcohol.

I am 18 years or older and have carefully read, understand, and attest that all the information in this form is true.

Signature Type it as you would sign it. The date will be time-stamped on your e-mail.

You may

before you

To submit another application, first

Meanwhile, thank you for doing your part to ensure the safety of your fellow Barefoot Contessa Photo Adventures participants. We look forward to working with you.

Barefoot Contessa Photo Adventures
310 Lafayette Drive
Hillsborough, NC 27278
1-919-643-3036 before 9pm ET