Post COVID-19 Sports/Physical Activity Clearance Form Affirmation
Please complete this form for your child to participate in physical education classes, physical activities and sports after testing COVID-19 positive .  We recommend you consult with your health care provider.
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Email *
Student Last Name: *
Student First Name: *
Student Date of Birth: *
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Which building does your child attend? *
Required
Student's Grade: *
Does your child participate in interscholastic sports?
Clear selection
Is your child experiencing shortness of breath? *
Is your child experiencing palpitations/fluttering of the heart? *
Is your child experiencing lightheadedness/fainting? *
Is your child experiencing chest pain? *
By submitting this form and typing my full name below, I affirm that the above information is accurate and can fully participate in sports and physical activities. *
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