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COVID WAIVER CHECK
Getting you back to community. Complete a daily health check to keep you and your community safe. You must fill out before you enter the studio for practice.
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* Indicates required question
Email
*
Your email
Full Name
*
Your answer
Have you tested positive for COVID-19 in the past 14 days?
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Yes
No
Have you travelled to a known "hotspot" or restricted state as documented by the Public Health Authority in the last 14 days?
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Yes
No
Have you had a new or worsening cough within the last 14 days?
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Yes
No
Have you had difficulty breathing or shortness of breath within the last 14 days?
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Yes
No
Have you had a sore throat or persistent cough within the last 14 days?
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Yes
No
Have you experienced headaches, body aches, chills, or fatigue within the last 14 days?
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Yes
No
Have you experienced abdominal pain, nausea/vomiting, or diarrhea within the last 14 days?
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Yes
No
Within the last 14 days, have you comin in contact with a person with a confirmed or suspected case of COVID-19?
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Yes
No
Do you feel feverish or do you have a body temperature greater than 100.4° F (38° C)? (You will be temperature check when you enter.)
*
Yes
No
Enter Initials before submitting
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Your answer
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