COVID-19 Policy Acknowledgement & Health Attestation (required for facility entry)

FCTV remains committed to providing a safe and welcoming environment. The COVID-19 new normal necessitates that we institute new protocols including requiring anyone entering to sign our COVID-19 Policy Acknowledgement & Health Attestation form before being allowed entry to the Falmouth Community Media Center.


Please Read
Please indicate your level of COVID-19 vaccination.
(Fully vaccinated occurs after receiving the second dose of the two-dose vaccine (Moderna or Pfizer) or two weeks after the single-dose (J & J) vaccine.)

Please sign your name and initials and date the form below.