Participant Health Attestation

Pursuant to the State of New Hampshire Universal Guidelines, everyone participating in Northeast Passage programs is required to attest to their current health for COVID-19 related symptoms prior to attending programs or picking up rental equipment. This health attestation includes certain mandatory questions that must be asked as well as documenting body temperature prior to participating with Northeast Passage.

You must complete an attestation each day you participate with us.

I attest (acknowledge or certify) that prior to participating with Northeast Passage that:

  • Myself and the individuals listed have not tested positive for COVID-19 in the last 14 days.
  • Myself and the individuals listed are not subject to a medical advisory or other guidance to self-quarantine.
  • Myself and the individuals listed have not been in close contact with a person with a confirmed case of COVID-19.*
  • Myself and the individuals listed have not had a temperature of 100.0 degrees Fahrenheit or above and have not felt feverish in the last 72 hours. You must take your temperature within 3 hours of arrival.
  • Myself and the individuals listed have not experienced any respiratory symptoms including a runny nose, sore throat, cough, or shortness of breath.
  • Myself and the individuals listed have not experienced any new muscle aches or chills.
  • Myself and the individuals listed have not experienced any new change in my sense of taste or smell.

If you are sick, have one or more of the above symptoms (even mild symptoms), have had a fever above 100.0 degrees Fahrenheit or felt feverish in the last 72 hours, have been in close contact with a confirmed case of COVID-19,* or tested positive for COVID-19:

  • You can not attend Northeast Passage programs or pick up rental equipment.
  • Contact Northeast Passage at 603-862-0070 or northeast.passage@unh.edu to cancel your reservations or registration.
  • Consult your primary care provider about COVID-19 testing, or seek testing through a public testing option, such as a State-run testing center, local health department, or ConvenientMD.

Close contact for personnel working in the line of duty (e.g. EMTs, nurses, doctors, police and fire), following occupational safety and health protocols, using required personal protective equipment (such as properly fit-tested respirators/N95 and disposable PPE), and decontamination procedures is excepted.

THIS FORM IS TO BE SUBMITTED THE DAY OF YOUR PARTICIPATION WITH US.

I attest (acknowledge or certify) to this full health attestation: