Responsible Party is the operator of the food service site, or another party as may be designated by the operator who shall be responsible for meeting NYS standards.
NOTE: For indoor events up to 100 attendees and outdoor events up to 200 attendees, this form DOES NOT need to be submitted
Please refer to the New York State Department of Health
for Food Services During the COVID-19 Public Health Emergency” for a full explanation of requirements. This guidance is posted on
the Monroe County Department of Public Health website.
I am the Responsible Party for the Event listed. I have reviewed all applicable New York State interim guidance for event activities and operations during the
COVID-19 public health emergency, and I affirm that I have read and understand my obligation to operate this event in accordance with such guidance. I understand
that the Event may be subject to inspection by the Monroe County Department of Public Health to ensure compliance with all provisions of the guidance.
I understand that it is my responsibility to submit a full list of Event attendees, including their full names, dates of birth, addresses, phone numbers and
email addresses, to COVID19@MonroeCounty.gov within 48 hours following the end of the Event, and maintain a record of
the aforementioned sign-in data for a minimum period of 28 days.