COVID-19 Pre-screening Questionnaire ({{gravity-field-id-3}})


The health and safety of Lone Prairie Camp's campers, rental guests and staff is our top priority and we are committed to heeding current provincial and federal government restrictions. As part of those measures, we appreciate you taking the time to complete this COVID-19 Pre-screening Questionnaire and encourage you to review the information available at the above links.
  1. The Alberta Health Services COVID-19 SELF-ASSESSMENT (https://myhealth.alberta.ca/Journey/COVID-19/Pages/Assessment.aspx) has been truthfully completed today () for and the Alberta Health Services COVID-19 SELF-ASSESSMENT did not recommend self-quarantine nor COVID-19 testing.
  2. I acknowledge that I have access to Lone Prairie Camp's COVID-19 Policies & Procedures.

It is important that this document is signed by the participant (or their parent/guardian if the participant is under 18 years old) on the day of arrival. Please complete the Alberta Health Services COVID-19 SELF-ASSESSMENT and digitally sign this document before arrival but not before the day of arrival.

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Signature Certificate
Document name: COVID-19 Pre-screening Questionnaire ({{gravity-field-id-3}})
lock iconUnique Document ID: aef7219691c8af1e1cded5facca8095cfb4744e0
Timestamp Audit
June 19, 2020 6:33 pm MDTCOVID-19 Pre-screening Questionnaire ({{gravity-field-id-3}}) Uploaded by LPC Registrar - registrar@loneprairiecamp.com IP 209.222.162.205
June 19, 2020 6:46 pm MDT Document owner info@loneprairiecamp.com has handed over this document to registrar@loneprairiecamp.com 2020-06-19 18:46:29 - 69.168.161.253