Port Kells SKSC Daily Health Questionnaire

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

This intent of this form is similar to the BC COVID-19 Self Assessment Tool (https://bc.thrive.health/covid19/en).

By completing this questionnaire in an honest and daily fashion, it creates a simple tool for SKSC to:
** Monitor the overall health of the team,
** Help in the prevention of spreading COVID-19

REQUIRED
** Swimmers are required to complete the form the day of workout, before heading to the pool for every workout they attend
** Each swimmer must have their own form
** 11 & Under swimmers must have a guardian fill it out

Email *

Swimmer's Name *

Please enter swimmer's name as registered with SKSC (first and last name). Only 1 swimmer per form.

Please select your group *

Group A

Group B

Group C

Group D

Coach

Are you experiencing any of the following: Severe difficulty breathing (e.g. struggling to breathe or speaking in single words), severe chest pain, having a very hard time waking up, feeling confused, losing consciousness? *

Yes

Clear form

Never submit passwords through Google Forms.

This form was created inside of Surrey Knights Swim Club. Report Abuse

Forms