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Pre-Trip COVID-19 Screening Questionnaire
& Acknowledgment of Policies
(Please complete this within 48 hours prior to your trip start)

The following COVID-19 screening questionnaire and policies are necessary to reduce risk to Alpine Endeavors clients and guides. All clients and guides must pass this pre-trip screening and sign the acknowledgment of policies in order to participate in a trip.

In addition, please be aware any clients who are traveling from another state need to be aware of the travel restrictions for NYS.

AS OF February, 10, 2022, Governor Kathy Hochul announced the indoor mask-or-vaccine requirement will be lifted and will remain optional for businesses, to enforce.

For any transport with Alpine Endeavors, or client transport of guides, all clients must wear a mask or provide proof of vaccination whenever we drive in a vehicle.

All travelers, domestic and international, should continue to follow all CDC travel requirements.

For More INFO in the NYS COVID Travel Restrictions, please visit: https://coronavirus.health.ny.gov/covid-19-travel-advisory

Please read thoroughly and honestly answer the following:

COVID-19 Questionnaire

 May 12, 2024 

First Participant's Name

First Name*

Middle Name

Last Name*
First Participant's Date of Birth*
First Participant's Information

COVID-19 Questionnaire

1. Are you vaccinated for COVID 19?*
2. Have you, or has anyone you have been in close contact with, tested positive for, or was suspected to have COVID-19 - still pending test results - in the past 14 days (if in a healthcare setting, close contact is concerning only if personal protective equipment was not used)?*
3. Within the last 2 weeks, have you experienced any of the following COVID-19 symptoms including: fever of 100 degrees or greater, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. Has anyone you are in close contact with had any COVID-19 symptoms in the last 14 days? These symptoms include: fever, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. If you selected YES to any questions above. Have you met the NYS State guidelines for Quarantine: "Individuals exposed to COVID-19 can end their quarantine after 10 days without a testing requirement as long as no symptoms have been reported during the quarantine period. After day 10 is reached, individuals must continue monitoring for symptoms through day 14 and if any develop, they should immediately self-isolate and contact the local health department or their healthcare provider to report this change and determine if they should seek testing."*
N/A
Yes
NO
6. Participants and any guests who have received the COVID-19 vaccine must still adhere to the NY State public health policies related to COVID 19, in addition to Alpine Endeavors' policies (face coverings, social distancing, etc. )
I Acknowledge

In addition to the above, I understand and acknowledge the following COVID Policies:

1. All individuals must wear a mask or provide proof of vaccination whenever traveling with an Alpine Endeavors guide in a vehicle.

Masks are still required for unvaccinated individuals, face coverings will be worn wherever wearing them would not compromise safety.

2. Unvaccinated Individuals should maintain 6 feet of physical distance from others when possible. However, due to the inherent nature of hiking, climbing and skiing, this may not always be possible.

3. We recommend washing your hands with soap and water, or use at least 60% alcohol hand sanitizer after touching common surfaces and gear, especially before eating, drinking or touching your face, if possible.

4. Groups that are large enough to be subject to a local, state, or federal group size restriction will travel and congregate appropriately so as to abide by those restrictions.

5. Trips may be ended early if guide feels clients fail to abide by our policies.

I Agree
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

COVID-19 Questionnaire

1. Are you vaccinated for COVID 19?*
2. Have you, or has anyone you have been in close contact with, tested positive for, or was suspected to have COVID-19 - still pending test results - in the past 14 days (if in a healthcare setting, close contact is concerning only if personal protective equipment was not used)?*
3. Within the last 2 weeks, have you experienced any of the following COVID-19 symptoms including: fever of 100 degrees or greater, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. Has anyone you are in close contact with had any COVID-19 symptoms in the last 14 days? These symptoms include: fever, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. If you selected YES to any questions above. Have you met the NYS State guidelines for Quarantine: "Individuals exposed to COVID-19 can end their quarantine after 10 days without a testing requirement as long as no symptoms have been reported during the quarantine period. After day 10 is reached, individuals must continue monitoring for symptoms through day 14 and if any develop, they should immediately self-isolate and contact the local health department or their healthcare provider to report this change and determine if they should seek testing."*
N/A
Yes
NO
6. Participants and any guests who have received the COVID-19 vaccine must still adhere to the NY State public health policies related to COVID 19, in addition to Alpine Endeavors' policies (face coverings, social distancing, etc. )
I Acknowledge

In addition to the above, I understand and acknowledge the following COVID Policies:

1. All individuals must wear a mask or provide proof of vaccination whenever traveling with an Alpine Endeavors guide in a vehicle.

Masks are still required for unvaccinated individuals, face coverings will be worn wherever wearing them would not compromise safety.

2. Unvaccinated Individuals should maintain 6 feet of physical distance from others when possible. However, due to the inherent nature of hiking, climbing and skiing, this may not always be possible.

3. We recommend washing your hands with soap and water, or use at least 60% alcohol hand sanitizer after touching common surfaces and gear, especially before eating, drinking or touching your face, if possible.

4. Groups that are large enough to be subject to a local, state, or federal group size restriction will travel and congregate appropriately so as to abide by those restrictions.

5. Trips may be ended early if guide feels clients fail to abide by our policies.

I Agree
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

COVID-19 Questionnaire

1. Are you vaccinated for COVID 19?*
2. Have you, or has anyone you have been in close contact with, tested positive for, or was suspected to have COVID-19 - still pending test results - in the past 14 days (if in a healthcare setting, close contact is concerning only if personal protective equipment was not used)?*
3. Within the last 2 weeks, have you experienced any of the following COVID-19 symptoms including: fever of 100 degrees or greater, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. Has anyone you are in close contact with had any COVID-19 symptoms in the last 14 days? These symptoms include: fever, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. If you selected YES to any questions above. Have you met the NYS State guidelines for Quarantine: "Individuals exposed to COVID-19 can end their quarantine after 10 days without a testing requirement as long as no symptoms have been reported during the quarantine period. After day 10 is reached, individuals must continue monitoring for symptoms through day 14 and if any develop, they should immediately self-isolate and contact the local health department or their healthcare provider to report this change and determine if they should seek testing."*
N/A
Yes
NO
6. Participants and any guests who have received the COVID-19 vaccine must still adhere to the NY State public health policies related to COVID 19, in addition to Alpine Endeavors' policies (face coverings, social distancing, etc. )
I Acknowledge

In addition to the above, I understand and acknowledge the following COVID Policies:

1. All individuals must wear a mask or provide proof of vaccination whenever traveling with an Alpine Endeavors guide in a vehicle.

Masks are still required for unvaccinated individuals, face coverings will be worn wherever wearing them would not compromise safety.

2. Unvaccinated Individuals should maintain 6 feet of physical distance from others when possible. However, due to the inherent nature of hiking, climbing and skiing, this may not always be possible.

3. We recommend washing your hands with soap and water, or use at least 60% alcohol hand sanitizer after touching common surfaces and gear, especially before eating, drinking or touching your face, if possible.

4. Groups that are large enough to be subject to a local, state, or federal group size restriction will travel and congregate appropriately so as to abide by those restrictions.

5. Trips may be ended early if guide feels clients fail to abide by our policies.

I Agree
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

COVID-19 Questionnaire

1. Are you vaccinated for COVID 19?*
2. Have you, or has anyone you have been in close contact with, tested positive for, or was suspected to have COVID-19 - still pending test results - in the past 14 days (if in a healthcare setting, close contact is concerning only if personal protective equipment was not used)?*
3. Within the last 2 weeks, have you experienced any of the following COVID-19 symptoms including: fever of 100 degrees or greater, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. Has anyone you are in close contact with had any COVID-19 symptoms in the last 14 days? These symptoms include: fever, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. If you selected YES to any questions above. Have you met the NYS State guidelines for Quarantine: "Individuals exposed to COVID-19 can end their quarantine after 10 days without a testing requirement as long as no symptoms have been reported during the quarantine period. After day 10 is reached, individuals must continue monitoring for symptoms through day 14 and if any develop, they should immediately self-isolate and contact the local health department or their healthcare provider to report this change and determine if they should seek testing."*
N/A
Yes
NO
6. Participants and any guests who have received the COVID-19 vaccine must still adhere to the NY State public health policies related to COVID 19, in addition to Alpine Endeavors' policies (face coverings, social distancing, etc. )
I Acknowledge

In addition to the above, I understand and acknowledge the following COVID Policies:

1. All individuals must wear a mask or provide proof of vaccination whenever traveling with an Alpine Endeavors guide in a vehicle.

Masks are still required for unvaccinated individuals, face coverings will be worn wherever wearing them would not compromise safety.

2. Unvaccinated Individuals should maintain 6 feet of physical distance from others when possible. However, due to the inherent nature of hiking, climbing and skiing, this may not always be possible.

3. We recommend washing your hands with soap and water, or use at least 60% alcohol hand sanitizer after touching common surfaces and gear, especially before eating, drinking or touching your face, if possible.

4. Groups that are large enough to be subject to a local, state, or federal group size restriction will travel and congregate appropriately so as to abide by those restrictions.

5. Trips may be ended early if guide feels clients fail to abide by our policies.

I Agree
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

COVID-19 Questionnaire

1. Are you vaccinated for COVID 19?*
2. Have you, or has anyone you have been in close contact with, tested positive for, or was suspected to have COVID-19 - still pending test results - in the past 14 days (if in a healthcare setting, close contact is concerning only if personal protective equipment was not used)?*
3. Within the last 2 weeks, have you experienced any of the following COVID-19 symptoms including: fever of 100 degrees or greater, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. Has anyone you are in close contact with had any COVID-19 symptoms in the last 14 days? These symptoms include: fever, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. If you selected YES to any questions above. Have you met the NYS State guidelines for Quarantine: "Individuals exposed to COVID-19 can end their quarantine after 10 days without a testing requirement as long as no symptoms have been reported during the quarantine period. After day 10 is reached, individuals must continue monitoring for symptoms through day 14 and if any develop, they should immediately self-isolate and contact the local health department or their healthcare provider to report this change and determine if they should seek testing."*
N/A
Yes
NO
6. Participants and any guests who have received the COVID-19 vaccine must still adhere to the NY State public health policies related to COVID 19, in addition to Alpine Endeavors' policies (face coverings, social distancing, etc. )
I Acknowledge

In addition to the above, I understand and acknowledge the following COVID Policies:

1. All individuals must wear a mask or provide proof of vaccination whenever traveling with an Alpine Endeavors guide in a vehicle.

Masks are still required for unvaccinated individuals, face coverings will be worn wherever wearing them would not compromise safety.

2. Unvaccinated Individuals should maintain 6 feet of physical distance from others when possible. However, due to the inherent nature of hiking, climbing and skiing, this may not always be possible.

3. We recommend washing your hands with soap and water, or use at least 60% alcohol hand sanitizer after touching common surfaces and gear, especially before eating, drinking or touching your face, if possible.

4. Groups that are large enough to be subject to a local, state, or federal group size restriction will travel and congregate appropriately so as to abide by those restrictions.

5. Trips may be ended early if guide feels clients fail to abide by our policies.

I Agree
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

COVID-19 Questionnaire

1. Are you vaccinated for COVID 19?*
2. Have you, or has anyone you have been in close contact with, tested positive for, or was suspected to have COVID-19 - still pending test results - in the past 14 days (if in a healthcare setting, close contact is concerning only if personal protective equipment was not used)?*
3. Within the last 2 weeks, have you experienced any of the following COVID-19 symptoms including: fever of 100 degrees or greater, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. Has anyone you are in close contact with had any COVID-19 symptoms in the last 14 days? These symptoms include: fever, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. If you selected YES to any questions above. Have you met the NYS State guidelines for Quarantine: "Individuals exposed to COVID-19 can end their quarantine after 10 days without a testing requirement as long as no symptoms have been reported during the quarantine period. After day 10 is reached, individuals must continue monitoring for symptoms through day 14 and if any develop, they should immediately self-isolate and contact the local health department or their healthcare provider to report this change and determine if they should seek testing."*
N/A
Yes
NO
6. Participants and any guests who have received the COVID-19 vaccine must still adhere to the NY State public health policies related to COVID 19, in addition to Alpine Endeavors' policies (face coverings, social distancing, etc. )
I Acknowledge

In addition to the above, I understand and acknowledge the following COVID Policies:

1. All individuals must wear a mask or provide proof of vaccination whenever traveling with an Alpine Endeavors guide in a vehicle.

Masks are still required for unvaccinated individuals, face coverings will be worn wherever wearing them would not compromise safety.

2. Unvaccinated Individuals should maintain 6 feet of physical distance from others when possible. However, due to the inherent nature of hiking, climbing and skiing, this may not always be possible.

3. We recommend washing your hands with soap and water, or use at least 60% alcohol hand sanitizer after touching common surfaces and gear, especially before eating, drinking or touching your face, if possible.

4. Groups that are large enough to be subject to a local, state, or federal group size restriction will travel and congregate appropriately so as to abide by those restrictions.

5. Trips may be ended early if guide feels clients fail to abide by our policies.

I Agree
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

COVID-19 Questionnaire

1. Are you vaccinated for COVID 19?*
2. Have you, or has anyone you have been in close contact with, tested positive for, or was suspected to have COVID-19 - still pending test results - in the past 14 days (if in a healthcare setting, close contact is concerning only if personal protective equipment was not used)?*
3. Within the last 2 weeks, have you experienced any of the following COVID-19 symptoms including: fever of 100 degrees or greater, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. Has anyone you are in close contact with had any COVID-19 symptoms in the last 14 days? These symptoms include: fever, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. If you selected YES to any questions above. Have you met the NYS State guidelines for Quarantine: "Individuals exposed to COVID-19 can end their quarantine after 10 days without a testing requirement as long as no symptoms have been reported during the quarantine period. After day 10 is reached, individuals must continue monitoring for symptoms through day 14 and if any develop, they should immediately self-isolate and contact the local health department or their healthcare provider to report this change and determine if they should seek testing."*
N/A
Yes
NO
6. Participants and any guests who have received the COVID-19 vaccine must still adhere to the NY State public health policies related to COVID 19, in addition to Alpine Endeavors' policies (face coverings, social distancing, etc. )
I Acknowledge

In addition to the above, I understand and acknowledge the following COVID Policies:

1. All individuals must wear a mask or provide proof of vaccination whenever traveling with an Alpine Endeavors guide in a vehicle.

Masks are still required for unvaccinated individuals, face coverings will be worn wherever wearing them would not compromise safety.

2. Unvaccinated Individuals should maintain 6 feet of physical distance from others when possible. However, due to the inherent nature of hiking, climbing and skiing, this may not always be possible.

3. We recommend washing your hands with soap and water, or use at least 60% alcohol hand sanitizer after touching common surfaces and gear, especially before eating, drinking or touching your face, if possible.

4. Groups that are large enough to be subject to a local, state, or federal group size restriction will travel and congregate appropriately so as to abide by those restrictions.

5. Trips may be ended early if guide feels clients fail to abide by our policies.

I Agree
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

COVID-19 Questionnaire

1. Are you vaccinated for COVID 19?*
2. Have you, or has anyone you have been in close contact with, tested positive for, or was suspected to have COVID-19 - still pending test results - in the past 14 days (if in a healthcare setting, close contact is concerning only if personal protective equipment was not used)?*
3. Within the last 2 weeks, have you experienced any of the following COVID-19 symptoms including: fever of 100 degrees or greater, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. Has anyone you are in close contact with had any COVID-19 symptoms in the last 14 days? These symptoms include: fever, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. If you selected YES to any questions above. Have you met the NYS State guidelines for Quarantine: "Individuals exposed to COVID-19 can end their quarantine after 10 days without a testing requirement as long as no symptoms have been reported during the quarantine period. After day 10 is reached, individuals must continue monitoring for symptoms through day 14 and if any develop, they should immediately self-isolate and contact the local health department or their healthcare provider to report this change and determine if they should seek testing."*
N/A
Yes
NO
6. Participants and any guests who have received the COVID-19 vaccine must still adhere to the NY State public health policies related to COVID 19, in addition to Alpine Endeavors' policies (face coverings, social distancing, etc. )
I Acknowledge

In addition to the above, I understand and acknowledge the following COVID Policies:

1. All individuals must wear a mask or provide proof of vaccination whenever traveling with an Alpine Endeavors guide in a vehicle.

Masks are still required for unvaccinated individuals, face coverings will be worn wherever wearing them would not compromise safety.

2. Unvaccinated Individuals should maintain 6 feet of physical distance from others when possible. However, due to the inherent nature of hiking, climbing and skiing, this may not always be possible.

3. We recommend washing your hands with soap and water, or use at least 60% alcohol hand sanitizer after touching common surfaces and gear, especially before eating, drinking or touching your face, if possible.

4. Groups that are large enough to be subject to a local, state, or federal group size restriction will travel and congregate appropriately so as to abide by those restrictions.

5. Trips may be ended early if guide feels clients fail to abide by our policies.

I Agree
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

COVID-19 Questionnaire

1. Are you vaccinated for COVID 19?*
2. Have you, or has anyone you have been in close contact with, tested positive for, or was suspected to have COVID-19 - still pending test results - in the past 14 days (if in a healthcare setting, close contact is concerning only if personal protective equipment was not used)?*
3. Within the last 2 weeks, have you experienced any of the following COVID-19 symptoms including: fever of 100 degrees or greater, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. Has anyone you are in close contact with had any COVID-19 symptoms in the last 14 days? These symptoms include: fever, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. If you selected YES to any questions above. Have you met the NYS State guidelines for Quarantine: "Individuals exposed to COVID-19 can end their quarantine after 10 days without a testing requirement as long as no symptoms have been reported during the quarantine period. After day 10 is reached, individuals must continue monitoring for symptoms through day 14 and if any develop, they should immediately self-isolate and contact the local health department or their healthcare provider to report this change and determine if they should seek testing."*
N/A
Yes
NO
6. Participants and any guests who have received the COVID-19 vaccine must still adhere to the NY State public health policies related to COVID 19, in addition to Alpine Endeavors' policies (face coverings, social distancing, etc. )
I Acknowledge

In addition to the above, I understand and acknowledge the following COVID Policies:

1. All individuals must wear a mask or provide proof of vaccination whenever traveling with an Alpine Endeavors guide in a vehicle.

Masks are still required for unvaccinated individuals, face coverings will be worn wherever wearing them would not compromise safety.

2. Unvaccinated Individuals should maintain 6 feet of physical distance from others when possible. However, due to the inherent nature of hiking, climbing and skiing, this may not always be possible.

3. We recommend washing your hands with soap and water, or use at least 60% alcohol hand sanitizer after touching common surfaces and gear, especially before eating, drinking or touching your face, if possible.

4. Groups that are large enough to be subject to a local, state, or federal group size restriction will travel and congregate appropriately so as to abide by those restrictions.

5. Trips may be ended early if guide feels clients fail to abide by our policies.

I Agree
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

COVID-19 Questionnaire

1. Are you vaccinated for COVID 19?*
2. Have you, or has anyone you have been in close contact with, tested positive for, or was suspected to have COVID-19 - still pending test results - in the past 14 days (if in a healthcare setting, close contact is concerning only if personal protective equipment was not used)?*
3. Within the last 2 weeks, have you experienced any of the following COVID-19 symptoms including: fever of 100 degrees or greater, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. Has anyone you are in close contact with had any COVID-19 symptoms in the last 14 days? These symptoms include: fever, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. If you selected YES to any questions above. Have you met the NYS State guidelines for Quarantine: "Individuals exposed to COVID-19 can end their quarantine after 10 days without a testing requirement as long as no symptoms have been reported during the quarantine period. After day 10 is reached, individuals must continue monitoring for symptoms through day 14 and if any develop, they should immediately self-isolate and contact the local health department or their healthcare provider to report this change and determine if they should seek testing."*
N/A
Yes
NO
6. Participants and any guests who have received the COVID-19 vaccine must still adhere to the NY State public health policies related to COVID 19, in addition to Alpine Endeavors' policies (face coverings, social distancing, etc. )
I Acknowledge

In addition to the above, I understand and acknowledge the following COVID Policies:

1. All individuals must wear a mask or provide proof of vaccination whenever traveling with an Alpine Endeavors guide in a vehicle.

Masks are still required for unvaccinated individuals, face coverings will be worn wherever wearing them would not compromise safety.

2. Unvaccinated Individuals should maintain 6 feet of physical distance from others when possible. However, due to the inherent nature of hiking, climbing and skiing, this may not always be possible.

3. We recommend washing your hands with soap and water, or use at least 60% alcohol hand sanitizer after touching common surfaces and gear, especially before eating, drinking or touching your face, if possible.

4. Groups that are large enough to be subject to a local, state, or federal group size restriction will travel and congregate appropriately so as to abide by those restrictions.

5. Trips may be ended early if guide feels clients fail to abide by our policies.

I Agree
Parent or Guardian's Email Address

Email*
A signed copy of this waiver will be sent to the email address you provide.
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

COVID-19 Questionnaire

1. Are you vaccinated for COVID 19?*
2. Have you, or has anyone you have been in close contact with, tested positive for, or was suspected to have COVID-19 - still pending test results - in the past 14 days (if in a healthcare setting, close contact is concerning only if personal protective equipment was not used)?*
3. Within the last 2 weeks, have you experienced any of the following COVID-19 symptoms including: fever of 100 degrees or greater, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. Has anyone you are in close contact with had any COVID-19 symptoms in the last 14 days? These symptoms include: fever, chills, cough, shortness of breath or difficulty breathing, new loss of taste or smell, muscle or body aches, headache, congestion or runny nose, sore throat, nausea or vomiting, or diarrhea?*
4. If you selected YES to any questions above. Have you met the NYS State guidelines for Quarantine: "Individuals exposed to COVID-19 can end their quarantine after 10 days without a testing requirement as long as no symptoms have been reported during the quarantine period. After day 10 is reached, individuals must continue monitoring for symptoms through day 14 and if any develop, they should immediately self-isolate and contact the local health department or their healthcare provider to report this change and determine if they should seek testing."*
N/A
Yes
NO
6. Participants and any guests who have received the COVID-19 vaccine must still adhere to the NY State public health policies related to COVID 19, in addition to Alpine Endeavors' policies (face coverings, social distancing, etc. )
I Acknowledge

In addition to the above, I understand and acknowledge the following COVID Policies:

1. All individuals must wear a mask or provide proof of vaccination whenever traveling with an Alpine Endeavors guide in a vehicle.

Masks are still required for unvaccinated individuals, face coverings will be worn wherever wearing them would not compromise safety.

2. Unvaccinated Individuals should maintain 6 feet of physical distance from others when possible. However, due to the inherent nature of hiking, climbing and skiing, this may not always be possible.

3. We recommend washing your hands with soap and water, or use at least 60% alcohol hand sanitizer after touching common surfaces and gear, especially before eating, drinking or touching your face, if possible.

4. Groups that are large enough to be subject to a local, state, or federal group size restriction will travel and congregate appropriately so as to abide by those restrictions.

5. Trips may be ended early if guide feels clients fail to abide by our policies.

I Agree
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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