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Our Lady of the Snows Catholic Academy
Nursery-8th Grade | Floral Park, NY
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Daily Family Form
Date
Date Format: MM slash DD slash YYYY
You are filling this out for: 06/17/2021
Parent/Guardian Name
*
First
Last
Parent/Guardian Email
*
Child Name
*
First
Last
Child Grade
*
Nursery
Pre-K A (Amarain)
Pre-K B (Lopes)
Pre-K C (Gately)
Pre-K D (Banes)
Kindergarten A (Bigeni)
Kindergarten B (Danza)
1st Grade A (Sirico)
1st Grade B (Barone)
2nd Grade A (McKeever)
2nd Grade B (Bamberger)
3rd Grade A (Brandt)
3rd Grade B (Paskor)
4th Grade A (Rasa)
4th Grade B (Gaines)
5th Grade A (Morris)
5th Grade B (Flynn)
6th Grade A (Flatley)
6th Grade B (Fragale)
7th Grade A (Frullo)
7th Grade B (Quinn)
8th Grade A (Aichinger)
8th Grade B (Ross)
P
arents:
Please complete this short check each morning and report your child’s information in the morning before your child leaves for school.
If the answer is
YES
to any question , please
do not
bring your child to school and contact your medical professional.
Health Screening Questions
Is your child or a household member currently waiting for the results of a COVID-19 test?
*
No. The student may go to school.
Yes. The student may not go to school.
In the past 10 days, Has your child experienced any symptoms of COVID-19 , including a fever of 100.0 F or greater, new cough, loss of taste or smell, shortness of breath, sore throat, headache, nasal congestion, runny nose (sniffles), stomach upset?
*
No. The student may go to school.
Yes. The student may not go to school.
In the past 10 days has your child gotten a lab confirmed positive COVID-19 test result (not a blood test) that was positive for COVID-19 result? Please note the 10days is measured from the day you were tested, not the day you received the results.
*
No. The student may go to school.
Yes. The student may not go to school.
To the best of your knowledge , in the past 10 days has your child been in close contact (within 6 feet for at least 10 minutes over 24 hour period) with anyone who has tested positive for COVID -19 or who has been told they have symptoms of COVID-19 ?
*
No. The student may go to school.
Yes. The student may not go to school.
In the last 10 days has your child or a household member traveled internationally or traveled for longer than 24 hours other than to New Jersey, Pennsylvania, Connecticut, Massachusetts or Vermont?
*
No. The student may go to school.
Yes. The student may not go to school.
YOUR CHILD DOES NOT MEET THE REQUIREMENTS TO GO TO SCHOOL TODAY
*
Confirm: I understand that I have selected YES to one of the questions above, and that my child DOES NOT MEET THE REQUIREMENTS to go to school today.
CAPTCHA
Email
This field is for validation purposes and should be left unchanged.
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