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Mandatory Declaration of Health for participants, volunteers, staff and all involved in the Showcase of Citrus 5K on February 27th, 2021, must be signed within 2 days of race day to be valid.
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 February 27th's Showcase of Citrus 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 Showcase of Citrus 5K live event if I fall under or live with someone in these categories:
People over 65 years of age
People who have chronic lung disease, moderate to severe asthma, or severe heart disease;
People who are immunocompromised: those who have undergone or are undergoing cancer treatment, bone marrow or organ transplantation; anyone with immune deficiencies, poorly controlled HIV or AIDS, or had prolonged use of corticosteroids; and smokers;
People of any age with class III or severe obesity; or
Anyone diagnosed with the following underlying conditions: diabetes, liver disease, and persons with chronic kidney disease undergoing dialysis.
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