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I am over 19 years old at the time of your Regional Qualifying Round
*For verification purposes pursuant to 18 U.S.C. §§ 2256 et seq.
Are you fully vaccinated against COVID-19? (i.e., have you received both doses of either the Moderna or Pfizer vaccines or one dose of the Johnson & Johnson vaccine at least 2 weeks prior to January 1, 2022?)
If you are fully vaccinated, which vaccine did you receive?
Please list the date(s) when you received your dose(s) of the vaccine: