Johnston Youth Panthers Spring Flag COVID Health Form

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Johnston Panthers are committed to ensuring the safest and healthiest season possible.

This form must be completed each day prior to arriving at practice. .

Please read the following information carefully:
-A mask must be worn at all times over the mouth and nose.
-You are allowed to remove your masks while drinking water.
-6ft social distancing must be maintained at all times when athletes are not practicing.
-Temperature checks will also be done for every volunteer before entering the practice field.
-Anyone that has experienced COVID-19 symptoms, has tested positive for COVID-19, or has been in contact with someone experiencing symptoms, or testing positive for COVID-19 will not be allowed to practice until producing a negative COVID-19 test, or quarantining for a minimum of 10 days, symptom free, as advised by the CDC.

Below are the symptoms that have been defined by the CDC as COVID-19 symptoms:
Cough
Nasal Congestion
Shortness of Breath
Difficulty Breathing
Fever
Sore Throat
Muscle Pain
Chills
Nausea
Vomiting
Loss of Taste
Loss of Smell

Failure to comply with any of the above guidelines will result in immediate dismissal from the Johnston Panthers.

Please note that this form must be filled out for each athlete. Do not add siblings onto the same form.

* Required

Athlete's or Coaches Name (only 1 per form) *

Email address *

I Attest: I understand and will follow the aforementioned guidelines. * *

Yes

I Attest: I have taken my temperature and it is the following. * *

I Attest: I, anyone living in my home, or anyone that I have come into close contact with is not experiencing any two, or more, of the following symptoms: Cough, Nasal Congestion, Shortness of Breath, Difficulty Breathing, Fever, Sore Throat, Muscle Pain, Chills, Nausea, Vomiting, Loss of Taste, Loss of Smell * *

Yes

I Attest: I, anyone living in my home, or anyone that I have come into close contact with is not waiting to be tested for COVID-19 nor is waiting for the results of a COVID-19 test. * *

Yes

I Attest: I, anyone living in my home, or anyone that I have come into close contact has not tested positive for COVID-19 in the last 14 days. * *

Yes

I Attest: Should I, or anyone living in my home or those I come in close contact with test positive with COVID-19, I will notify the Johnston Panthers. * *

Yes

I agree that failure to comply and properly report the above can lead to my dismissal from the Johnston Panthers Spring Flag League * *

Yes

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