SESSION WELLNESS CHECK-IN
Grande Prairie Gymnastics and Cheerleading

The information in this questionnaire is collected under the authority of FOIP section 33 (c) and will be used and disclosed solely for the purposes of determining fitness for entering Grande Prairie Gymnastics & Cheerleading during the COVID-19 pandemic. The questionnaire only relates to new symptoms or a worsening of symptoms related to allergies, chronic or pre-existing conditions. Those with symptoms related to pre-existing conditions or allergies can still enter the facility. This Wellness form is a Session wellness form and needs filling out only once but attendance in each class does confirm they are healthy enough (as outlined below), to attend.

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Athlete(s) Full Name - If more than one name, separate with comma (,) *
Does your child have any of the following symptoms which are NEW or WORSENED? FEVER, Temperature of 38 degrees Celsius or higher? COUGH, Continuous, more than usual, not related to other known causes or conditions such as asthma? SHORTNESS of BREATH, Continuous, out of breath, unable to breathe deeply, not related to other known causes or conditions such as asthma? LOSS of TASTE or SMELL, Not related to other known causes or conditions like allergies or neurological disorders? *
Does the child have any new onset (or worsening) of the following other symptoms? Chills, Sore throat/painful swallowing, Runny nose/congestion, Feeling unwell/fatigued, Nausea, (vomiting and/or diarrhea), Unexplained loss of appetite, Muscle/joint aches, Headache, Conjunctivitis (commonly known as pink eye)? *
If you answered “YES” to ONE symptom in either question above, keep your child home and monitor for 24 hours. If their symptom is improving after 24 hours, they can return to gymnastics activities when they feel well enough to do so.
If you answered “YES” to TWO OR MORE symptoms in either question above, keep your child home, use the AHS Online Assessment Tool or call Health Link 811 to determine if testing is recommended. Your child can return to school and activities once their symptoms go away as long as it has been at least 24 hours since their symptoms started.
If the child answered “NO” to all questions, your child may attend their gymnastic classes.
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