COVID-19 DISCLOSURE FORM

COVID-19 DISCLOSURE FORM

Due to the novel Coronavirus (COVID-19), Wild Women Tribe requires all participants for retreats and workshops to disclose any COVID-19 related symptoms to protect others in attendance and the community at large. This disclosure is mandatory and must be submitted within three days prior to attending an in-person event.

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Thank you for your response. ✨

Hey sister! Thank you for submitting your Covid-19 disclosure form before your outdoor adventure with likeminded women like YOU. We are looking forward to WANDERing with you soon! If you have any questions or concerns, email us: connect@wildwomentribe.net

Name

Phone

Date (YYYY-MM-DD)

I certify that I have not been knowingly in direct contact with anyone who has tested positive for Covid-19 or have not had a positive test result for 10 days prior to the event:

COVID-19 SYMPTOMS DISCLOSURE

Please certify that you do not currently have any of the following symptoms, or have not had them for at least 10 days prior to the event:
*Cough
*Shortness of breath or difficulty breathing
*Fever
*Chills
*Repeated shaking with chills
*Muscle pain
*Headache
*Sore throat
*New loss of taste or smell

Social distancing, also called “physical distancing,” means keeping space between yourself and other people outside of your home. To practice social or physical distancing:
*Stay at least 6 feet (about 2 arms’ length) from other people
*Do not gather in groups
*Stay out of crowded places and avoid mass gatherings
I commit to the above social distancing guidelines while in attendance at Wild Women Tribe events:

Thank you for your response. ✨

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