Daily COVID-19 Health Screening

Please complete this form before arriving to each day of camp. This form must be completed each day by all students, staff, YLP members, and anyone else entering the building for summer camp every day

If answer to any of the following questions is YES, you must stay home.


By entering my name above, I acknowledge the contagious nature of COVID-19 and on behalf of myself, my child(ren), and our family voluntarily, I assume the risk that my child(ren) and I, and any member of the family, may be exposed to or infected by COVID-19 by attending activities with DMR Adventures and that such exposure or infection may result in personal injury, illness, permanent disability, and death. 

What is the nature of your visit?

Are you experiencing any of the following symptoms?

  • Fever/chills with a temperature of 100.4˚F or above
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • Loss of taste or smell
  • Sore Throat
  • Congestion or runny nose
  • Nausea or vomiting and/or diarrhea

Have you been in close contact with an individual who has tested positive for COVID-19 within the past 14 days?

Your form has been submitted. Please wait to be redirected to the confirmation page.

Please confirm that you have fully completed the form and try again. 

If this error persists, please ask a staff member for a physical copy of this form.