First Minor's Information
I, the undersigned, attest to the following: (please tick the box beside each applicable attestation). In the case of a minor, "I" refers to that minor.
To the best of my knowledge, I do not have the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19, nor have I had it within the past 14 days
To the best of my knowledge, I have not been exposed to someone who has the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19 within the past 14 days
Within the past 14 days, I have not experienced any of the following that are new and not related to allergies or pre-existing conditions: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose
To the best of my knowledge, within the past 14 days, I have not been exposed to someone who expressed any of the following symptoms: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose
I have not travelled outside Nova Scotia during the past 14 days
Second Minor's Information
I, the undersigned, attest to the following: (please tick the box beside each applicable attestation). In the case of a minor, "I" refers to that minor.
To the best of my knowledge, I do not have the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19, nor have I had it within the past 14 days
To the best of my knowledge, I have not been exposed to someone who has the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19 within the past 14 days
Within the past 14 days, I have not experienced any of the following that are new and not related to allergies or pre-existing conditions: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose
To the best of my knowledge, within the past 14 days, I have not been exposed to someone who expressed any of the following symptoms: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose
I have not travelled outside Nova Scotia during the past 14 days
Third Minor's Information
I, the undersigned, attest to the following: (please tick the box beside each applicable attestation). In the case of a minor, "I" refers to that minor.
To the best of my knowledge, I do not have the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19, nor have I had it within the past 14 days
To the best of my knowledge, I have not been exposed to someone who has the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19 within the past 14 days
Within the past 14 days, I have not experienced any of the following that are new and not related to allergies or pre-existing conditions: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose
To the best of my knowledge, within the past 14 days, I have not been exposed to someone who expressed any of the following symptoms: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose
I have not travelled outside Nova Scotia during the past 14 days
Fourth Minor's Information
I, the undersigned, attest to the following: (please tick the box beside each applicable attestation). In the case of a minor, "I" refers to that minor.
To the best of my knowledge, I do not have the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19, nor have I had it within the past 14 days
To the best of my knowledge, I have not been exposed to someone who has the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19 within the past 14 days
Within the past 14 days, I have not experienced any of the following that are new and not related to allergies or pre-existing conditions: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose
To the best of my knowledge, within the past 14 days, I have not been exposed to someone who expressed any of the following symptoms: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose
I have not travelled outside Nova Scotia during the past 14 days
Fifth Minor's Information
I, the undersigned, attest to the following: (please tick the box beside each applicable attestation). In the case of a minor, "I" refers to that minor.
To the best of my knowledge, I do not have the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19, nor have I had it within the past 14 days
To the best of my knowledge, I have not been exposed to someone who has the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19 within the past 14 days
Within the past 14 days, I have not experienced any of the following that are new and not related to allergies or pre-existing conditions: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose
To the best of my knowledge, within the past 14 days, I have not been exposed to someone who expressed any of the following symptoms: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose
I have not travelled outside Nova Scotia during the past 14 days
Sixth Minor's Information
I, the undersigned, attest to the following: (please tick the box beside each applicable attestation). In the case of a minor, "I" refers to that minor.
To the best of my knowledge, I do not have the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19, nor have I had it within the past 14 days
To the best of my knowledge, I have not been exposed to someone who has the novel coronavirus COVID-19 or any variant of the novel coronavirus COVID-19 within the past 14 days
Within the past 14 days, I have not experienced any of the following that are new and not related to allergies or pre-existing conditions: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose
To the best of my knowledge, within the past 14 days, I have not been exposed to someone who expressed any of the following symptoms: persistent cough, fever higher than 38 degrees Celsius (100.4 degrees Fahrenheit), shortness of breath, sore throat, flu-like symptoms, runny nose
I have not travelled outside Nova Scotia during the past 14 days
By signing below, I confirm my understanding that I and/or my child may be refused participation in, or
be asked to leave, this trip/rental, with no option for refund of payment, if any of the above
attestations are found to be incorrect or if the status of those attestations changes between the time of
signing of this form and any time before the end of the trip/rental.