Ticket To Play
Daily screening for all Cary Charger Participants. You MUST answer all questions below.
Sign in to Google to save your progress. Learn more
Please enter your Child's First and Last Name *
Please enter today's date *
MM
/
DD
/
YYYY
Has your child had close contact (within 6 ft for at least 15 minutes) in the last 14 days with someone diagnosed with COVID 19, or has any health department advised him/her to quarantine? *
Within the past 10 days, has your child been diagnosed with COVID 19? *
Does your child have a fever (100.4° or higher) or chills? *
Does your child have a new shortness of breath or difficulty breathing? *
Does your child have a new cough (unrelated to allergies)? *
Does your child have a new loss of taste or smell? *
Please take and enter your child's temperature before they report to training and enter below. *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy