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2022 MINNESOTA VIKINGS COVID-19 BOOSTER CERTIFICATION

Effective immediately, media members that apply for accreditation to cover NFL events and to provide on-site Vikings coverage in any form at TCO Performance Center and U.S. Bank Stadium are required to obtain a COVID-19 booster.

 

Please note that in accordance with the NFL-NFLPA COVID-19 Protocols, the National Football League (“NFL”) and Minnesota Vikings Football, LLC (“Club”) require all media members to certify that they are fully vaccinated for COVID-19, including a booster shot (as defined by the CDC). Media members will not be granted access to the press box, field, interview rooms or team facilities unless they are fully vaccinated and boosted. Please refer to those Protocols for more detailed information.

Under the CDC’s recommendations:
• An individual that received their second Pfizer or Moderna shot to complete their primary vaccine series more than six months earlier should receive a booster shot.
• An individual that received their Johnson and Johnson shot more than two months earlier should receive a booster shot.

The following individuals are not subject to this requirement:
• An individual who is not eligible for a booster pursuant to the CDC definition; or
• An individual who has tested positive for COVID in the past 90 days; OR
• An individual who received monoclonal antibodies within the immediately preceding 90 days; OR
• An individual whose “S” antibody level on an antibody test administered via BRL at the club facility is 2500 or greater.

If you are a media member and have received a COVID-19 booster, you should complete this form. You are not required to provide any documentation related to your vaccination or any medical or genetic information as part of the certification process. If you do not complete this form, you are indicating that you have not received the booster shot for COVID-19. Any individual who is not currently subject to the requirement for boosters will be required to obtain the booster within 14 days of becoming eligible and complete this form.

Your information will only be used in our efforts to promote a safe workplace and will be treated as confidential information.

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Booster Information
By clicking below, I hereby certify that I have read and understood this Certification and received my COVID-19 booster.*
Yes

Date of Booster *
Type of Booster*
Pfizer
Moderna
Johnson & Johnson
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*

Last Name*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
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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