Sunday Health Screening (Winter 2021-2022)

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Players (or parents/guardians of players under 18) must fill out this form every Sunday before 5:00pm for entry into the Dome.

Players are asked to show up no earlier than 10-15 minutes before your game start and depart the Dome no longer than 15 minutes after your game/league/program.

Reminder: Full vaccination is required for participation in the league & entry into all Winter 2021-2022 Domes.

OCUA Return to Play Protocols:
Coming soon.

Facility-Specific Protocols:
https://www.ocua.ca/CovidResouceHub

Name of Player (First and Last) *

Name of Program or League *

Summit (U13/U17)

U10/U13 Youth Rec League

Date of Session *

YYYY

In the last 14 days, have you tested positive for COVID-19 or been advised by a doctor, health care provider or public health unit that you should currently be isolating or staying home? *

Yes

In the last 14 days, have you tested positive on a rapid antigen/home-based test and not completed a follow up test at an assessment centre? *

Yes

In the last 14 days, have you had close physical contact (and you are not fully vaccinated**) with someone you live with who is experiencing any new COVID-19 symptoms and/or waiting for a test result or with with someone who tested positive for COVID-19 or who is considered a probable case? *

Yes

In the last 14 days, have you5. travelled outside of Canada and been told to quarantine (per the federal quarantine requirements?)

Yes

Clear selection

Do you have any of the following new or worsening symptoms or signs? Symptoms should not be chronic or related to other known causes or conditions. *

Fever or chills

Difficulty breathing or shortness of breath

Cough or barking cough (croup)

Sore throat or trouble swallowing

Runny/stuffy nose or nasal congestion

Pink eye

Decrease or loss of smell or taste

Nausea, vomiting, diarrhea, abdominal pain

Headache that's unusual or long lasting

Falling down often

Not feeling well, extreme tiredness, sore muscles

None of the above

Required

By agreeing, I acknowledge that if at any time after submission of this form and prior to my actual session, any health situation with respect to COVID has changed I will refrain my group from attending the session. *

I agree

I disagree

Masks must be worn at all times in the facility, except for those who are actively participating. Spectators and unregistered spare players are NOT permitted inside the dome. *

I agree

I disagree

Submit

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