COVID-19 Vaccination Status – Miami March of the Living

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March of the Living 2023-2024 Application

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COVID-19 Vaccination Status

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Please complete all fields to the best of your ability.

Please be aware that the pandemic has been dynamic, and consequently, our Covid-related policies have also evolved. These policies are subject to change, and we will ensure that families are kept informed in case of any adjustments.

*Denotes a required field

Have you traveled domestically since March 2020?^*

Have you traveled out of the country since March 2020?^*

COVID-19 Vaccine - In accordance with the International March of the Living and the Ministry of Tourism in Israel, it is recommended that all March of the Living participants be fully vaccinated for COVID-19 by December 1, 2023.

We also highly recommend participants receive a flu vaccination as well. We are around vulnerable population specifically our Survivors and it is important that they maintain their health and safety throughout the program.

Are you vaccinated or plan to be vaccinated by December 2023?^*

One vaccine
Two vaccines
Two vaccines + Booster
Unvaccinated

Please indicate the name of the Vaccine^*

Pfizer
Moderna
Johnson & Johnson
Other

I acknowledge and agree to follow Covid-19 safety and prevention requirements as determined by Miami's March of the Living guidelines. Please note, a booster may be required depending on date of vaccination. I understand that these requirements might change throughout the program year locally and during travel as needed. These prevention measures may include a number of guidelines, one of which could be masking in certain settings to protect our Survivors.^*

Yes, I acknowledge

Admin use only (do not edit)

Registrant(Teen) Email Address^*

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Contact

4200 Biscayne Blvd #1, Miami, FL 33137
miamimotl@caje-miami.org