COVID Screening - PowerSKATE 2021/22
This questionnaire must be completed by each individual prior to (but not more than 3 hours before) participation in EACH training session.

Information is recorded on the Contact Tracing Log.

If you answer YES to any of the questions, you must NOT participate in the sport or activity.

Please complete the screening for EACH participant you are responsible for.
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Email Address *
Skater First Name *
Skater Last Name *
Parent/Guardian Name (First & Last) *
Skating Group *
Session Date
MM
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DD
/
YYYY
Session Start Time
Time
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