This information will solely be used to keep our friends and family safe. If you feel unwell following the event please contact our team via ricky@mindofmila.com. The following information will be erased 14 Days following the event : Nov. 18 2020

CORONAVIRUS DISEASE (COVID-19)

Name

First Name

Last Name

SUBJECTIVE FEVER

SHORTNESS OF BREATH

SORE THROAT

DIARRHEA (UNLESS DUE TO KNOWN CAUSE

NEW OR WORSENING COUGH

IN THE PAST 14 DAYS HAVE YOU HAD CONTACT WITH AN INDIVIDUAL DIAGNOSED WITH COVID-19?

IN THE PAST 14 DAYS HAVE YOU TRAVELED INTERNATIONALLY OR DOMESTICALLY?