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I___________________________________(name of participant, volunteer, staff, vendor) declare that today ____________________(date must be within 2 days of race day) am not infected nor have had or been in contact with someone experiencing any Covid 19 symptoms in the last 14 days prior to July 4th’s Clermont Freedom 5K. Such symptoms may include but not be limited to: cough, shortness of breath, or difficulty breathing, fever, chills, muscle pain, sore throat or new loss of taste of smell.
I also understand that I was encouraged not to participate in this FloDash 4th of July Clermont Freedom 5K live event if I fall under or live with someone in these categories:
Per executive order from Governor DeSantis, all individuals traveling from Connecticut, New Jersey, New York and Louisiana must isolate or quarantine for a period of 14 days from the time of entry into Florida. Travel from other domestic locations is at the discretion of the individual.
Last name, First name
Age on race day