Safety Pre‐Screening Questionnaire and Indemnity Agreement
Please fill out this questionnaire. You may present a) confirmation (live screen or screenshot) or a filled out paper form to the designated Safety Marshal at the gate entrance to the facility before the start of the swim meet. Participating Team Head coach or designee will be responsible to distribute this questionnaire to each Coach, Official, Volunteer, and Athlete who will be attending this meet.

𝗙𝗮𝗶𝗹𝘂𝗿𝗲 𝘁𝗼 𝗰𝗼𝗺𝗽𝗹𝗲𝘁𝗲 𝗮𝗻𝗱 𝘀𝘂𝗯𝗺𝗶𝘁 𝘁𝗵𝗶𝘀 𝗾𝘂𝗲𝘀𝘁𝗶𝗼𝗻𝗻𝗮𝗶𝗿𝗲 𝗮𝗻𝗱 𝗮𝗴𝗿𝗲𝗲𝗺𝗲𝗻𝘁 𝗺𝗮𝘆 𝗿𝗲𝘀𝘂𝗹𝘁 𝗶𝗻 𝗻𝗼 𝗮𝗰𝗰𝗲𝘀𝘀 𝘁𝗼 𝘁𝗵𝗲 𝗳𝗮𝗰𝗶𝗹𝗶𝘁𝘆
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Safety Pre‐Screening Questionnaire
Required for all athletes, coaches, officials, and volunteers to enter the pool facility

Club Team Name *
How many sessions will you be attending today? *
Which will be your first session today? *
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