COVID-19 Waiver

Statement of Symptoms and Mask Agreement

Pursuant to the Governor of New Hampshire’s Emergency Order 27, all registered guests must attest that they are not exhibiting any symptoms of COVID-19.

Symptoms Statement (required by all guests):

By signing this statement, I attest that no one in my party is currently exhibiting any symptoms of COVID-19 such as:

  1. Have been in close contact with a confirmed case of COVID-19 (NOTE: Healthcare workers caring for COVID-19 patients while wearing appropriate personal protective equipment should answer “no” to this question.)
  2. Fever in the last 48 hours
  3. Respiratory symptoms such as sore throat, cough, or shortness of breath
  4. Changes in a person’s sense of taste or smell

Name: ________________________________

Signed: ________________________________ Date: ______________

Mask agreement: All guests agree to wear masks in all indoor common areas throughout the hostel. (bedrooms excluded):

By signing this statement, I and all the individuals staying with me under my reservation agree to the hostel’s zero-tolerance mask policy:

  1. I will cover my mouth and nose with my mask in all indoor common areas throughout my stay.
  2. If I am drinking a beverage in the common areas, I will keep my mask on other than when I take a sip of my beverage.  
  3. If I am eating in the common areas,  I will remove my mask only for the short period of time in which I am eating. 
  4. If I do not comply with this policy, I will immediately lose access to the common areas for the remainder of my stay.
  5. If I violate this policy more than once, I will be asked to leave and will not receive a refund for my stay.

Name: ________________________________

Signed: ________________________________ Date: ______________