Palate to Palette 2021 Health and Safety Affidavit

This affidavit must be submitted to LAA before attending Palate to Palette. It is the responsibility of the person making the reservation to communicate this information to their guests. Masks will not be required at the event, but we encourage you to wear one when possible.

If you have any questions, please call (860) 434-7802 or email elsbeth@lymeartassociation.org

Name *

First

Last

Email *

Please check all the following to affirm:

Everyone in my party is fully vaccinated against Covid-19 or will have negative results from a Covid-19 test taken within 72 hours before the event.
My party will provide proof of vaccination if requested (or proof of a negative Covid-19 test). Proof of vaccination includes a CDC-issued vaccination card or a doctor’s note on office letterhead
If anyone in my party has symptoms of Covid-19, they will not attend the event.