Covid Vaccine Clinic August 13th, 2022 Question Title * 1. Please provide us with the name of child or adults that want to get vaccinated? Question Title * 2. If a child is getting vaccinated, please provide us with the child's date of birth Question Title * 3. Please provide us with the preferred vaccination Moderna Pfizer Question Title * 4. Please provide us with your contact information Name Address City/Town State/Province ZIP/Postal Code Email Address Phone Number Done