Sri Sharadamba Temple - Darshan Volunteer Sign Up

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26325 Halsted Road,Farmington Hills MI 48331

16 January, 2021

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Sri Sharadamba Temple - Darshan Volunteer Sign Up I attest that I DO NOT HAVE unexplained body aches I attest that I DO NOT HAVE sore throat not due to any pre-existing condition I attest that I DO NOT HAVE cough not due to any pre-existing condition I attest that I DO NOT HAVE hard time breathing I attest that I DO NOT HAVE fever over 100 degree Fahrenheit I attest that I DO NOT HAVE loss of Taste or Smell Please attest to all of these also: I attest that I have NOT knowingly been in close contact in the past 14 days with anyone who has tested positive for COVID-19 or who has or had any of the symptoms listed in the previous item here I attest that I have NOT Tested positive for COVID-19 in the past 14 days, or has experienced any symptoms of COVID-19 in the past 14 days

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